Hepatitis B: Symptoms, Treatment and Prevention in Pakistan

Hepatitis B is one of the most common serious infections in Pakistan, and many people who carry it feel completely well and have no idea. It spreads through blood and body fluids, often in childhood or at birth, and over decades it can silently damage the liver. The encouraging news is that hepatitis B can be prevented with a safe vaccine, and chronic infection can be controlled with regular monitoring and, when needed, antiviral tablets.

What is hepatitis B?

Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV). It can be acute, a short-term illness that clears in about six months, or chronic, when the virus stays in the body. The younger a person is when infected, the more likely it is to become chronic: about 9 in 10 infected babies develop chronic infection, compared with fewer than 1 in 20 healthy adults.

How hepatitis B spreads

• From an infected mother to her baby at birth
• Reused or unsterilised syringes and needles, including in clinics, dental work, tattooing and ear or nose piercing
• Shared razors, toothbrushes and nail clippers, and unsterile blades at the barber
• Unscreened blood transfusions
• Unprotected sex with an infected partner
• Sharing needles among people who use drugs

Hepatitis B does not spread through food, water, sharing plates and cups, hugging, handshakes, coughing or sneezing. A person with hepatitis B can live with the family and share meals safely.

Hepatitis B symptoms

Many people have no symptoms for years. In acute infection, symptoms appear 1 to 4 months after exposure and may include:

• Tiredness and weakness
• Loss of appetite, nausea and vomiting
• Pain in the upper right abdomen
• Dark urine and pale stools
• Yellow eyes and skin (jaundice)
• Joint pain and low fever

Chronic hepatitis B often shows no signs until liver damage is advanced, when swelling of the belly and legs, jaundice, bleeding and confusion can occur.

How is it diagnosed?

A blood test for HBsAg shows current infection. Further tests, including HBV DNA (viral load), liver enzymes (ALT), and an ultrasound or FibroScan, show how active the infection is and how much liver damage there is. Every adult should be tested at least once, and all pregnant women should be tested.

Treatment

• Acute hepatitis B usually needs rest, fluids and good food, and clears by itself in most adults. A doctor monitors the liver, and severe cases need hospital care.
• Chronic hepatitis B is not always treated. Many people need only regular monitoring, with blood tests and an ultrasound every 6 to 12 months. Treatment starts when tests show the virus is active and damaging the liver, or when there is cirrhosis.
• Antiviral tablets such as tenofovir and entecavir suppress the virus, protect the liver and lower the chance of cirrhosis and liver cancer. Lamivudine is an older option that is less preferred because the virus can become resistant. Treatment is often long-term.
• Do not stop antiviral tablets suddenly without your doctor’s advice. The virus can flare up and cause serious liver damage.

Living with hepatitis B

• Have regular check-ups, and a liver ultrasound every six months if you have cirrhosis or are at higher risk. See liver cancer symptoms and screening.
• Avoid alcohol completely.
• Do not take herbal products or unnecessary supplements that can harm the liver, and ask before taking any medicine, including painkillers.
• Keep a healthy weight, since fatty liver adds to the damage.
• Get vaccinated against hepatitis A.
• Cover cuts, never share razors, nail clippers or toothbrushes, and clean blood spills with bleach.
• Family members and sexual partners should be tested, and vaccinated if they are not immune.

Prevention: the hepatitis B vaccine

The vaccine is very safe and more than 95 percent effective. Babies receive it as part of the routine childhood immunisation schedule. Adults who were never vaccinated, healthcare workers, barbers, family contacts of carriers and people with diabetes or liver disease should get the three-dose course, usually at 0, 1 and 6 months. A blood test (anti-HBs) shows whether you are protected.

A baby born to a mother with hepatitis B should get the first vaccine dose, and an injection of hepatitis B immunoglobulin, within 12 to 24 hours of birth. This prevents infection in most cases. Tell your doctor early in pregnancy if you carry the virus.

Other protective steps: use a new, sealed syringe for every injection, make sure your dentist and barber sterilise their tools or use fresh blades, accept blood only from screened donors, and use condoms with a partner whose status is unknown.

When to see a doctor

• Yellow eyes or skin, dark urine, or persistent abdominal pain
• You have never been tested or vaccinated
• A family member has hepatitis B
• You are pregnant and have not been tested
• You carry hepatitis B and have not had a check-up in the past year

Key takeaways

• Hepatitis B spreads through blood, from mother to baby and through unsafe injections or razors, not through food or touch.
• Many carriers have no symptoms, so a simple blood test matters.
• Chronic infection is controlled with monitoring and, when needed, long-term antiviral tablets that must not be stopped suddenly.
• The vaccine is safe and highly effective, and babies and at-risk adults should have it.

Related medicines on Medimart

These are commonly used for prevention and treatment of hepatitis B, only on a doctor’s advice:

• Hepatitis B vaccine: prevents hepatitis B infection
• Tenofovir: an antiviral for chronic hepatitis B
• Lamivudine: an older antiviral used in selected cases

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse liver care medicines on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. Please get tested and vaccinated if you have not been.