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Hepatitis B

life science Maturity 11-13 Next article →

Hepatitis B is an infectious disease caused by the hepatitis B virus, often called HBV. This virus specifically targets the liver, which is a vital organ in the human body. HBV is one of five main hepatitis viruses, alongside types A, C, D, and E.

Hepatitis B virus v2 (3)
Hepatitis B virus v2 (3)

Understanding this virus is important because it can lead to serious long-term health problems. While many people show no signs of being sick, the virus can still cause significant damage to the liver over time.

The virus has a very complex life cycle inside the human body. It is a pararetrovirus, which means it uses a process called reverse transcription to replicate.

HBV replication
HBV replication

First, the virus enters a liver cell, known as a hepatocyte, by binding to a specific receptor on the cell surface. Once inside, the viral DNA must travel to the cell nucleus using helper proteins called chaperones. In the nucleus, the viral DNA is transformed into a stable form called covalently closed circular DNA, or cccDNA. This cccDNA then acts as a template to create new viral components. These components eventually assemble into new virus particles, which are released to infect other cells.

The physical structure of the virus is quite small and specialized.

HBV Genome
HBV Genome

An HBV particle, or virion, is between 30 and 42 nanometers in diameter. It consists of an outer lipid envelope and an inner core called a nucleocapsid. This core protects the viral DNA and an enzyme called DNA polymerase. The outer envelope contains surface antigens, known as HBsAg, which help the virus attach to new cells. Some scientists refer to the 42 nm infectious particles as "Dane particles." The virus's genome is made of circular DNA that is only partially double-stranded.

An infection with HBV can be classified into two distinct stages: acute and chronic. An acute infection is the initial illness that occurs shortly after exposure. Symptoms may appear between 30 and 180 days after contact. These symptoms can include nausea, vomiting, fatigue, and jaundice, which is a yellowing of the skin and eyes. Most people recover from an acute infection within a few weeks or months. However, if the infection lasts longer than six months, it is considered a chronic infection.

Hepatitis B virus phases of chronic infection
Hepatitis B virus phases of chronic infection

The risk of this becoming chronic is much higher for infants. About 90% of those infected at birth develop chronic HBV, compared to less than 10% of those infected after age five.

Chronic hepatitis B can be very dangerous because it often has no symptoms for a long time. Without treatment, the constant inflammation can lead to cirrhosis, which is severe scarring of the liver. This condition significantly increases the risk of developing hepatocellular carcinoma, or liver cancer. In fact, about 25% of people with chronic HBV will eventually develop cirrhosis or liver cancer. The virus can also cause issues outside of the liver, such as kidney problems or skin rashes. Because of these risks, doctors often use antiviral medications like tenofovir to help manage the disease.

Historically, hepatitis B was once known as "serum hepatitis." In the 1980s, many cases were linked to tattooing and acupuncture, but improved sterilization has made this much less common. Today, we know the virus is transmitted through contact with infectious blood or body fluids. This includes sexual contact, using contaminated needles, or vertical transmission from mother to child during birth. It is important to note that HBV is much more infectious than HIV. However, you cannot catch it through casual contact like hugging, kissing, or sharing utensils.

Global health organizations are working hard to control the spread of this virus. As of 2022, the hepatitis B vaccine is between 98% and 100% effective. This vaccine is given in several doses to ensure full protection.

hepatitis b incidence sdgs, World, 2021
hepatitis b incidence sdgs, World, 2021

The World Health Organization recommends that infants receive the vaccine within 24 hours of birth. As of 2021, 190 countries have national programs to provide this vaccine to babies. In 2019, an estimated 296 million people lived with chronic hepatitis B. This represents about 3.8% of the total global population. The WHO aims to eliminate viral hepatitis as a global public health threat by the year 2030.

Hepatitis B world map - DALY - WHO2004
Hepatitis B world map - DALY - WHO2004

The impact of the virus varies greatly depending on where you live. It is most prevalent in Africa, where it affects 7.5% of the population. The Western Pacific region also has high rates at 5.9%. In contrast, the infection rate is much lower in Europe at 1.5% and in the Americas at 0.5%. Some estimates suggest that one-third of all people in the world have been infected with hepatitis B at some point. By using vaccines, testing donated blood, and improving treatments, the world hopes to reduce these numbers significantly.

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🖼️ Images & Media (7)
File:Hepatitis_B_virus_v2_(3).svg
Hepatitis_B_virus_v2_(3).svg
File:HBV Genome.svg
HBV Genome.svg
File:HBV replication.png
HBV replication.png
File:Ground glass hepatocytes high mag cropped.jpg
Ground glass hepatocytes high mag cropped.jpg
File:Hepatitis B virus phases of chronic infection.png
Hepatitis B virus phases of chronic infection.png
File:Hepatitis B world map - DALY - WHO2004.svg
Hepatitis B world map - DALY - WHO2004.svg
File:hepatitis b incidence sdgs, World, 2021.svg
hepatitis b incidence sdgs, World, 2021.svg
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