Hepatitis B; Transmission, Prevention, Symptoms, & Treatment

Transmission and stages of the disease

As noted above, one of the most important modes of transmission of hepatitis B is sexual intercourse. The virus can be found in body fluids and is quickly passed down during sex. It is also found in the blood, and bloodborne transmission is very likely. That’s why blood transfusions should be tested for this virus, and donors are carefully selected to prevent the spread of this disease.

After the virus has infected a new host, it goes through 5 disease stages. Each one takes a while and may take longer to develop depending on the patient’s immune responses, the coinfection with other hepatitis viruses, age, sex, and other variables. The stages of the disease are as follows:

1. Immune tolerance phase: This is the incubation period of the disease, which lasts somewhere between 2 and 4 weeks. When a newborn baby gets the disease, the immune tolerance phase lasts years, sometimes decades. During this stage, there are no symptoms at all and no elevation of liver enzyme levels. The virus continues replicating, creating new copies in the liver tissue.
2. Immune active phase: The inflammatory reaction in the liver starts during this phase. Antibodies against hepatitis B can be found in the blood during this phase. In some patients, this automatically clears the infection, but in the process, it causes liver damage and acute symptoms for 3-4 weeks. In other cases, patients extend their condition as it becomes chronic. They can continue in this phase for up to 10 years until cirrhosis develops, and the body finally clears the virus.
3. Inactive chronic infection: This is a stationary and latent phase of the disease. The patient no longer has symptoms; viral replication is deficient, usually not measurable. Liver enzyme levels are typically normal, but HBsAg in the blood is positive.
4. Chronic disease: As noted above, some patients go from the immune active phase directly to chronic disease. Sometimes they develop acute symptoms, then inactive chronic infection, and finally, a chronic disease. In either case, chronic disease is probably one of the most dangerous because patients sometimes take years to realize they are infected with the hepatitis B virus.
5. Recovery: This is the last stage of the disease, where the virus is undetectable. However, after chronic disease, cirrhosis and hepatocellular carcinoma are both likely.