Liver products are here! The answers to the most pressing questions for hepatitis B patients are here

Hepatitis B (HBV) is a major public health problem worldwide. Although there have been important advances in drug treatment of hepatitis B in recent years, it is still a huge challenge for medical workers due to its huge number of patients.

To this end, WHO has proposed the ambitious goal of "eliminating viral hepatitis as a public health hazard by 2030". As grassroots medical workers, it is crucial to carry out scientific popularization.

1. How is hepatitis B transmitted?

According to Yiyang Central Hospital, HBV is transmitted from mother to child, through blood (including minor trauma to the skin and mucous membranes), and through sexual contact . In China, mother-to-child transmission is the main form of infection, accounting for 40%-50% of new infections, and most cases occur during the perinatal period, through the blood and/or body fluids of HBV-positive mothers. The mother's HBV-DNA level is closely related to the risk of HBV infection in the newborn. Mothers with positive HBeAg and high HBV-DNA levels are more likely to be infected from mother to child.

Adults are mainly infected through blood and sexual contact, including transfusion of blood and blood products that have not been strictly screened and tested, non-standard blood purification, non-standard invasive procedures (such as injections, surgery, and dental treatment procedures), and unprotected sexual behavior. HBV can also be transmitted through broken skin or mucous membranes, such as occupational exposure, pedicure, tattoos, ear piercing, and sharing of razors and toothbrushes.

2. If a child has hepatitis B, do family members need to be tested?

Generally speaking, family members are close contacts, and because HBV may be transmitted from mother to child, through sexual contact, and through blood, among family members, it is recommended that family members of HBV patients and carriers should undergo corresponding testing. If there is no hepatitis B surface antibody (anti-HBs) or the antibody titer is low, they should also be vaccinated with hepatitis B vaccine.

3. If you have hepatitis B, how should you get along with your family, friends, and colleagues?

HBV is not transmitted through the respiratory tract or digestive tract . Therefore, daily contact in study, work or life, such as working in the same office (including sharing computers, etc.), shaking hands, hugging, living in the same dormitory, eating in the same restaurant and sharing toilets, etc., without blood exposure, will not transmit HBV. Epidemiological and experimental studies have not found that HBV can be transmitted through blood-sucking insects (mosquitoes and bedbugs, etc.).

If your partner is positive for hepatitis B surface antigen, you should get the hepatitis B vaccine or use condoms; when the health status of your sexual partner is unknown, you should use condoms to prevent HBV and other blood-borne or sexually transmitted diseases.

Generally speaking, family members are close contacts, and because HBV may be transmitted from mother to child, through sexual contact, and through blood, among family members, it is recommended that family members of HBV patients and carriers should undergo corresponding testing . If there is no hepatitis B surface antibody (anti-HBs) or the antibody titer is low, they should also be vaccinated with hepatitis B vaccine.

4. What should I do if a family member accidentally comes into contact with the blood or body fluids of a hepatitis B patient?

If the contact's skin is intact, there is no need to worry about this. If the contact's skin is damaged, but the contact has been vaccinated against hepatitis B and has anti-HBs ≥ 10 IU/ml, the contact only needs to disinfect the wound.

If the contact person has skin damage and the anti-HBs titer is low or negative, or if the person's anti-HBs status is unclear, it is recommended to go to the hospital for testing of hepatitis B surface antigen and HBV-DNA as soon as possible, and recheck after 3 to 6 months. At the same time, hepatitis B vaccine and hepatitis B immunoglobulin are required.

5. If the mother is positive for hepatitis B surface antigen, can she breastfeed?

According to the latest guidelines, newborns can be breastfed by HBsAg-positive mothers after receiving hepatitis B immunoglobulin and hepatitis B vaccine within 12 hours of birth .

References

You Hong, Wang Fusheng, Li Taisheng. Guidelines for the prevention and treatment of chronic hepatitis B (2022 edition)[J]. Chinese Journal of Clinical Infectious Diseases, 2022, 15(6): 401-427

Hunan Medical Chat Special Author: Deng Kui from Yiyang Central Hospital

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(Edited by YH)