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November 23, 2009

Women's health: Combating a common virus

By Dr. Gerald F. Joseph Jr., American College of Obstetricians and Gynecologists president



Hepatitis B (HBV) is a viral infection that attacks the liver, the organ that filters and cleans the blood and

helps with digestion. Over time, HBV can destroy the cells of the liver and cause the organ to swell and eventually stop working. Hepatitis B is a common infection in the US—more than 46,000 new infections were reported in 2006.

Some people with a hepatitis infection will not have any symptoms, while others may experience muscle aches, fatigue, loss of appetite, nausea, dark-colored urine and light-colored stool, and yellowing of the skin and whites of the eyes (jaundice). See your doctor immediately if you have any of these symptoms.

Anyone can get HBV. It is spread by direct contact with bodily fluids—such as blood, semen, or vaginal fluids—of an infected person. Up to 60 percent of HBV infections are spread through contact with an infected sexual partner. Infants of mothers with HBV can be infected before or during delivery. Contaminated needles used for tattooing or IV drug use can spread HBV. You are also at an increased risk of contracting the disease if you live with an infected person, have sex with more than one partner, work in a job that involves contact with human blood, or receive blood transfusions or blood products. Individuals with these risk factors should talk to their doctor about getting screened for HBV.

If you test positive, do not donate blood or plasma or arrange to be an organ donor, do not share toothbrushes or razors or other objects that could be in touch with blood, and tell past and present sex partners and the people you live with of your condition.

In most adults, the infection will clear up on its own within a few weeks. Once the infection has cleared, the majority of sufferers will have immunity against getting it again in the future. However, an estimated 800,000 to 1.4 million Americans never fully get rid of it, putting them at risk for scarring (cirrhosis) of the liver, liver failure, or liver cancer.

There is no cure for HBV, but vaccination is available. Pregnant women who have risk factors and who have tested negative for HBV, infants and teens who haven’t been previously vaccinated, and high-risk adults should be vaccinated against HBV.

Chronic HBV infection can be treated with medication. If you have HBV or if your partner is infected, you should use condoms every time you have sex and avoid oral-anal contact.

For more information, the ACOG Patient Education Pamphlet “Protecting Yourself Against Hepatitis B” is available in English and Spanish at www.acog.org/publications/patient_education.

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