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Dr. Nancy Reau is an assistant professor of medicine at the University of Chicago’s Center for Liver Disease, where she specializes in treating hepatitis. Here are five things she says everyone should know about hepatitis B.
Hepatitis B is a silent threat. People with chronic infections may feel fine for a long time, even as the virus is causing damage to the liver. Recent evidence shows that during the immune tolerant phase, when most researchers had assumed the virus was quiet, the liver may be sustaining injury. By the time symptoms appear, liver damage may be advanced. That’s why it is so important to be tested if you have any reason to think you might have been exposed.
People infected with hepatitis B should be tested for hepatitis C and H.I.V. Both of these viruses can be transmitted via routes that are similar to hepatitis B. Co-infection raises the risk of complications. In addition, many doctors encourage people with hepatitis B infection to be vaccinated against hepatitis A to protect their livers from additional damage. Hepatitis A is typically transmitted in contaminated water or food.
Family members and close contacts of people infected with hepatitis B should be tested for the virus. If they have not been exposed to it, they should be vaccinated.
Not every person infected with hepatitis B needs to start treatment right away. Many people live with the virus and never develop serious symptoms. Most doctors counsel patients to wait until liver function tests and a biopsy show signs that the virus is beginning to cause damage. By waiting, doctors can limit the amount of time patients need to be treated and lower the risk that drug-resistant viruses will emerge.
Current drugs are very effective at controlling the virus and preventing damage. And because the liver can regenerate itself, some patients with advanced disease may see their condition improve significantly after beginning treatment.
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