Name : TAUPIK ROHMAN

CLASS : 2B NURSING

NPM : 16.156.O1.11.O72

A. What is hepatitis B?

Hepatitis B is a virus that infects the liver. Most adults who get it have it for a short
time and then get better. This is called acute hepatitis B.

Sometimes the virus causes a long-term infection, called chronic hepatitis B. Over
time, it can damage your liver. Babies and young children infected with the virus are
more likely to get chronic hepatitis B.

You can have hepatitis B and not know it. You may not have symptoms. If you do,
they can make you feel like you have the flu. But as long as you have the virus, you
can spread it to others.
B. What causes hepatitis B?
It's caused by the hepatitis B virus. It is spread through contact with the blood and
body fluids of an infected person.

You may get hepatitis B if you:

 Have sex with an infected person without using a condom.

 Share needles (used for injecting drugs) with an infected person.
 Get a tattoo or piercing with tools that weren't sterilized.
 Share personal items like razors or toothbrushes with an infected person.

A mother who has the virus can pass it to her baby during delivery. Medical experts
recommend that all pregnant women get tested for hepatitis B. If you have the virus,
your baby can get shots to help prevent infection with the virus.

You cannot get hepatitis B from casual contact such as hugging, kissing, sneezing,
coughing, or sharing food or drinks.

C. Complications
People with hepatitis B can sometimes develop serious liver problems. These
mostly affect people with an untreated long-term (chronic) infection.

Some of the main problems associated with hepatitis B include:

Cirrhosis

Scarring of the liver (cirrhosis) affects around one in five people with chronic
hepatitis B, often many years after they first got the infection.

Cirrhosis doesn't usually cause any noticeable symptoms until extensive damage to
the liver has occurred, when it can cause:
  tiredness and weakness
 loss of appetite
 weight loss
 feeling sick
 very itchy skin
 tenderness, pain, or swelling in the tummy
 swelling of the ankles

There's currently no cure for cirrhosis, although it's possible to manage the symptoms
and slow its progression. If the liver becomes severely damaged, a liver
transplant may be needed.

Read more about the treatments for cirrhosis.

Liver cancer

People with cirrhosis caused by hepatitis B have around a 1 in 20 chance of

developing liver cancer every year.

Symptoms of liver cancer include:

 unexplained weight loss

 loss of appetite
 feeling very full after eating, even if the meal was small
 feeling and being sick
 yellow skin and eyes (jaundice)

Treatment for liver cancer may involve surgery to remove the affected section of
liver, a procedure to destroy the cancerous cells, or a liver transplant.

Read more about the treatments for liver cancer.

Fulminant hepatitis B

In less than 1 in 100 cases, short-term (acute) hepatitis B can lead to a serious
problem called fulminant hepatitis B.

This is where the immune system attacks the liver and causes extensive damage to it.
It can lead to symptoms such as:

 confusion
 collapsing
 swelling of the tummy caused by a build-up of fluid
 severe jaundice

Fulminant hepatitis B can cause the liver to stop working properly and is often fatal if
not treated quickly.

D. What are the symptoms?

Signs and symptoms of hepatitis B range from mild to severe. They usually appear
about one to four months after you've been infected, although you could see them as
early as two weeks post-infection. Some people, usually young children, may not
have any symptoms.

Hepatitis B signs and symptoms may include:

 Abdominal pain
 Dark urine
 Fever
 Joint pain
 Loss of appetite
 Nausea and vomiting
 Weakness and fatigue
 Yellowing of your skin and the whites of your eyes (jaundice)

E. How Is Hepatitis B Diagnosed?

Hepatitis B infection is diagnosed with blood tests. These tests can detect
pieces of the virus in the blood (antigens), antibodies against the virus, and viral DNA
('viral load'). Blood tests for HBV are often done when routine blood work shows
abnormal liver function tests or in patients who are at an increased risk for exposure.
If a patient has had a large amount of vomiting or has not been able to take in liquids,
blood electrolytes may also be checked to ensure that the patient's blood chemistry is
in balance.

Other tests may be ordered to rule out other medical conditions.

X-rays and other diagnostic images are needed only in very unusual circumstances.

If a patient is diagnosed with chronic hepatitis B, they will need regular visits to their
health care practitioner. Blood tests can help determine how active the infection is
and whether there has been damage to the liver.

Blood tests alone may not be enough to guide treatment in chronic HBV. Other tests
include:

 CT scan or ultrasound: These diagnostic imaging tests are used to detect the
extent of liver damage and may also detect cancer of the liver caused by
chronic hepatitis B.
 Liver biopsy: This involves removal of a tiny piece of the liver. It is usually
done by inserting a long needle into the liver and withdrawing the tissue. The
tissue is examined under a microscope to detect changes in the liver. A biopsy
may be done to detect the extent of liver damage or to evaluate how well a
treatment is working.

F. Treatment
Treatment to prevent hepatitis B infection after exposure

If you know you've been exposed to the hepatitis B virus and aren't sure if you've
been vaccinated, call your doctor immediately. An injection of immunoglobulin (an
antibody) given within 12 hours of exposure to the virus may help protect you from
getting sick with hepatitis B. Because this treatment only provides short-term
protection, you also should get the hepatitis B vaccine at the same time, if you never
received it.
Treatment for acute hepatitis B infection

If your doctor determines your hepatitis B infection is acute — meaning it is short-

lived and will go away on its own — you may not need treatment. Instead, your
doctor might recommend rest, proper nutrition and plenty of fluids while your body
fights the infection. In severe cases, antiviral drugs or a hospital stay is needed to
prevent complications.

Treatment for chronic hepatitis B infection

Most people diagnosed with chronic hepatitis B infection need treatment for the rest
of their lives. Treatment helps reduce the risk of liver disease and prevents you from
passing the infection to others. Treatment for chronic hepatitis B may include:

 Antiviral medications.

Several antiviral medications — including entecavir (Baraclude),

tenofovir (Viread), lamivudine (Epivir), adefovir (Hepsera) and telbivudine
(Tyzeka) — can help fight the virus and slow its ability to damage your liver.
These drugs are taken by mouth. Talk to your doctor about which medication
might be right for you.

 Interferon injections.

Interferon alfa-2b (Intron A) is a man-made version of a substance

produced by the body to fight infection. It's used mainly for young people
with hepatitis B who wish to avoid long-term treatment or women who might
want to get pregnant within a few years, after completing a finite course of
therapy. Interferon should not be used during pregnancy. Side effects may
include nausea, vomiting, difficulty breathing and depression.

 Liver transplant.

If your liver has been severely damaged, a liver transplant may be an

option. During a liver transplant, the surgeon removes your damaged liver and
replaces it with a healthy liver. Most transplanted livers come from deceased
donors, though a small number come from living donors who donate a portion
of their livers.
G. Physical Examination
The physical examination findings in hepatitis B disease vary from minimal to
impressive (in patients with hepatic decompensation), according to the stage of
disease.

Patients with acute hepatitis usually do not have any clinical findings, but the
physical examination can reveal the following:

 Low-grade fever
 Jaundice (10 days after appearance of constitutional symptomatology, lasting
for 1-3 mo)
 Hepatomegaly (mildly enlarged, soft liver)
 Splenomegaly (5-15%)
 Palmar erythema (rarely)
 Spider nevi (rarely)

The physical examination of patients with chronic hepatitis B virus (HBV) infection
can reveal stigmata of chronic liver disease such as the following:

 Hepatomegaly
 Splenomegaly
 Muscle wasting
 Palmar erythema
 Spider angioma
 Vasculitis (rarely)

Patients with cirrhosis may have the following findings:

 Ascites
 Jaundice
 History of variceal bleeding
 Peripheral edema
 Gynecomastia
 Testicular atrophy
 Abdominal collateral veins (caput medusa)