Synonyms in the broadest sense
Hepatitis B virus infection, inflammation of the liver, inflammation of the liver parenchyma, acute and chronic viral hepatitis B, hepatitis B virus (HBV), infectious jaundice of virus type B.
Definition Hepatitis B
Hepatitis B virus-induced liver inflammation is notifiable and is the most common cause of viral hepatitis worldwide. In about 90% of infected persons the disease heals without consequences. In the remaining 10%, the infection becomes chronic and in about 1% of chronically infected hepatitis B patients, liver cirrhosis and/or hepatocellular carcinoma (HCC) develops as a result of the permanent inflammation. The therapy of chronic hepatitis B is possible with so-called viralstatic drugs, but is not always successful. Therefore, preventive vaccination is the most important and safest measure to avoid hepatitis B infection and decimation of the virus carriers as a constant source of infection.
Frequencies
In Germany, 55% of all viral hepatitis is caused by HBV (hepatitis B virus) and the population is infected by 0.2%. Worldwide, 300 to 420 million people are chronically infected with HBV, which corresponds to about 5 to 7% of the total world population. The number of people infected and thus potential carriers of hepatitis B is estimated at about 600,000 in Germany.
Every year, about 50 to 60,000 new cases are added. Approximately 2000 infected persons die as a result of hepatitis B every year. Every year, an average of 0.5% of all patients with chronic hepatitis B develop liver cell cancer.
Symptoms of Hepatitis
The symptoms of patients infected with hepatitis B vary greatly. About 1/3 of the patients never develop symptoms (asymptomatic) and the disease often remains undetected. About 1/3 of patients develop general, non-specific symptoms of the disease about 60-120 days after infection (incubation period), such as headache, fatigue, exhaustion, loss of appetite, weight loss, fever, joint and muscle pain and a slight feeling of pressure in the right upper abdomen.
This process is called “anicteric”, as there is no yellowing of the skin and eyes (icterus). Approximately 1/3 of patients suffering from hepatitis B develop jaundice after the above-mentioned general complaints, with yellowing of the white of the eyes and skin, discoloration of the bowel movements and darkening of the urine (beer urine). This so-called “icteric” form begins after about 3-10 days, reaches its peak after about 1-2 weeks and usually disappears again after 2-4 weeks.
How quickly the acute hepatitis B infection heals and how severe the course of the disease is depends on the patient’s general state of health and age. For example, an acute hepatitis B infection in adults heals completely in 90% of cases. Hepatitis B infection in children, on the other hand, usually leads to much worse courses of disease and is only completely cured in 10% of cases.
In 90% of children, an acute infection turns into a chronic hepatitis B infection (> 6 months the virus is detectable in the blood). Chronic hepatitis B is characterized by a favored development of a connective tissue transformation of the liver tissue (liver fibrosis) and a shrunken liver (liver cirrhosis), which carries an increased risk of liver cancer. In chronic hepatitis B infection, liver function can be increasingly impaired and, although only in a few patients, leads to liver failure.
Jaundice is a typical symptom of hepatitis B disease, but only occurs in about 1/3 of infected patients. It usually follows the first stage, which is dominated by flu-like symptoms. The whole skin or only the sclerae (the white in the eyes) may turn yellow. This yellow coloration is called jaundice. It lasts for several weeks and then disappears completely.
