In children, the infection is often asymptomatic, but this does not mean that it is harmless: precisely the absence of symptoms makes progression towards chronic form easier, which can remain silent for years before causing serious damage
“It is so small, why should we already have to vaccinate it against hepatitis B?” Paolo’s parents, a few weeks old. They have never heard of a case among their acquaintances and wonder if the vaccination in question does not represent an excessive precaution for a disease that seems so rare.
In reality hepatitis B (hepatitis B In English), infection that can go unnoticed but that can also become chronic and cause serious liver damage over time, it is much more widespread than it is believed and, especially in small children, involves a high risk of chronicization. That’s why early vaccination is recommended: to protect the little ones immediately from a potentially dangerous but silent infection.
In this article we will deepen how hepatitis B is contracted and how it is transmitted, how the diagnosis is made and why the vaccine is so important.
What is hepatitis B
It is an infectious liver disease caused by the hepatitis B virus (HBV). When a person is infected, the virus attacks liver cells and can cause inflammation. This inflammation can be acute, that is, temporary, or chronic, that is, persistent over time. In some cases, the infection is resolved spontaneously without consequences, while in others it can clearly evolve to cause liver cirrhosis or liver carcinoma (liver cancer).
Hepatitis B one of the main causes of liver disease in the world, with over 250 million chronic people with a global level carriers.
Hepatitis B: the cause
The cause is the hepatitis B virus (HBV, Hepatitis B Virus), a very resistant and infectious DNA virus. It can survive outside the body even for seven days and maintain the infectious capacity. Just come into contact with very reduced quantities of infected blood to contract the infection.
“How do you take hepatitis B?” It is important to specify that as regards hepatitis, contagion does not take place through random contact: hugs, handshakes, coughs or food sharing do not involve risks. However, the exchange of personal objects (razors, teeth toothbrushes) or contaminated tools (needles, tattoos, piercings) can be dangerous if not adequately sterilized.
Hepatitis and transmission
How is hepatitis B transmits? The main transmission routes are:
- Perinatal, or from the mother to the child during childbirth. This is the most frequent mode in countries where the virus is endemic.
- Sexual, or through unprotected relationships with an infected person.
- Parenteral, or through direct contact with infected blood, for example through needles, syringes, surgical instruments or contaminated dentists.
In young children, the vertical transmission (mother-child) is the most worrying: if the virus is transmitted to birth, the risk of developing a chronic form is very high, even in the absence of symptoms. In addition, prolonged domestic contacts with a chronic bearer (for example a family member) can represent a source of infection in the early years of life. However, breastfeeding in mothers with chronic infection is not contraindicated, even if it is necessary to follow the signs for mothers with chronic infection. In the case of a child with chronic HBV infection, there are no contraindications to the attendance of the school.
Hepatitis B: Can the transmission take place via saliva?
Yes, the infection can also be contracted through contact with saliva (and also tears, urine, vaginal liquid and sperm), but these transmission methods are less common than direct blood transmission.
Symptoms of hepatitis B
Many adults who contract hepatitis B do not show symptoms. When instead the symptoms of hepatitis B are evident, generally include:
- intense and prolonged tiredness;
- moderate fever;
- muscle and joint pain;
- nausea, vomiting and loss of appetite;
- I made clear and dark urine;
- jaundice (yellow color and eyes color);
- generalized itching.
The incubation period of hepatitis B varies from one to six months. In children, the infection is often asymptomatic, but this does not mean that it is harmless: precisely the absence of symptoms makes progression towards the chronic form easier, which can remain silent for years before causing damage.
Diagnosis of hepatitis B
The diagnosis of hepatitis B is carried out with a simple blood test that searches for the presence of specific markers:
- Hbsag: indicates an ongoing infection.
- HBCAB: reports contact with the virus.
- HBSAB: Protective antibodies, present after healing or vaccination.
In case of chronic infection, they also evaluate:
- the levels of HBV-DNA (viral charge);
- the values of transaminase (liver function);
- Any signs of liver damage through ultrasound or liver elastography (non -invasive examination that measures the rigidity of the liver and allows to evaluate the level of fibrosis, or the degree of healing of the organ).
Epatitis B chronic
When the hepatitis B virus persists in the body for over six months, we speak of chronic hepatitis. As for pediatric patients, this condition concerns:
- about 90% of infected newborn baby;
- 30% of children under 5 years;
- 5-10% of adults.
In the case of chronic hepatitis B, what are life expectancy? The chronic form can clearly evolve for decades, causing fibrosis, cirrhosis and liver cancer. However, thanks to the progress of medicine, many people with chronic hepatitis B can live for a long time and well, limiting the onset of complications, if you follow regularly.
Hepatitis B: treatment and treatment
Is hepatitis B curable? Is it possible to heal definitively?
Acute hepatitis B, in most cases, is resolved spontaneously without specific therapy. However, it is essential to guarantee:
- adequate rest;
- balanced nutrition;
- hydration;
- periodic checks to monitor the evolution of infection.
In the case of chronic hepatitis B, the treatment aims to reduce viral replication and prevent complications. In this regard, they are used:
- antiviral drugs (for example Tenofovir or Entecavir);
- Ultrasound controls and dosages of the viral charge;
- monitoring of liver function.
Veccino for hepatitis B
The Veccino against hepatitis B is considered one of the most effective and safe vaccines available today. He drastically reduced the incidence of the disease in the countries where he was introduced in early childhood.
In Italy, it is mandatory for infants since 1991 and is administered through hexavalent vaccination (which also covers diphtheria, tetanus, pertussis, polio and Haemophilus influenzae Type B). The administrations take place in:
- 3 months;
- 5 months;
- 11 months.
Children born from virus carriers receive a dose of specific immunoglobulins in the first 12 hours of life, together with the first dose of the vaccine: a measure that allows you to drastically reduce the risk of vertical transmission.
The vaccine is well tolerated, it does not contain live viruses and cannot in any way cause the disease. The most common side effects are slight: redness at the headquarters of the injection or transient fever.
It should also be noted that the vaccine has a very high effectiveness, so after completing the administration cycle it is able to prevent infection in 95% of cases.
