Many people know about hepatitis B, but they have different perceptions of it. Some people are afraid to talk about hepatitis B and see it as a tiger and a beast, and are afraid to avoid it. Some people carry hepatitis B themselves, but they don’t care about it, and drink and stay up late as usual. I think that both of these perceptions are undesirable.
At present, China is a large hepatitis B country, although after more than 20 years of hepatitis B vaccination, the national hepatitis B virus surface antigen carrier rate from 9,75% in 1992 to 7,18% in 2006, but China’s population base is large, there are still 1,200 million people carrying the hepatitis B virus, of which 30 million are chronic hepatitis B patients, some infected people can evolve into cirrhosis or even liver cancer. Therefore, we should be fully aware of the danger of hepatitis B. Here, we call on the whole society to “understand hepatitis B correctly and control it scientifically”.
Since hepatitis B is an infectious disease, we would like to know how hepatitis B is transmitted. (Moderator)
First of all, let’s understand what are the sources of hepatitis B infection, transmission routes and susceptible groups?
The source of infection is hepatitis B patients or hepatitis B carriers, and the transmission routes are blood transmission, mother-to-child transmission and sexual contact transmission. People who are susceptible are those who do not have hepatitis B surface antibody and can be infected.
Blood is an important means of transmission of hepatitis B. It is more common to be infected with hepatitis B during blood transfusions, and syringe needles and surgical instruments are also important sources. You can only reduce your chances of transmitting hepatitis B by not coming into contact with blood as much as possible.
Mother-to-child transmission of hepatitis B accounts for a significant proportion of cases. Mothers with hepatitis B can transmit the hepatitis B virus to their newborns, and mothers carrying hepatitis B surface antigen in particular are the main type of infection. Newborn babies are given hepatitis B immunoglobulin, which can effectively stop mother-to-child transmission of hepatitis B, with an efficiency of more than 90%.
Inappropriate sexual intercourse can easily provoke hepatitis B. Semen and vaginal secretions can transmit hepatitis B virus, and in Europe and the United States, sexual contact is the most important way of adult hepatitis B virus transmission. In China, hepatitis B is not yet considered a classical sexually transmitted disease. The insurance method for prevention is to get the hepatitis B vaccine or use condoms.
So, here I would say that there is a “special way” to spread hepatitis B. Ordinary contact is not contagious.
So, what lifestyles do not transmit hepatitis B?
Kissing is generally not contagious. Scientific experiments have proven that saliva containing the hepatitis B virus cannot infect orangutans, so kissing is generally not contagious. Unless the other party’s mouth is bleeding, then kissing may transmit hepatitis B.
Mosquito bite will not spread hepatitis B. Hepatitis B virus in the body of the mosquito can only survive 48 hours, while the interval between the mosquito blood in more than 72 hours, so the mosquito bite will not spread hepatitis B.
Dine together will not transmit hepatitis B. Hepatitis B virus is not transmitted through the gastrointestinal tract, hepatitis B is not a gastrointestinal infectious disease. Sharing meals and eating utensils is not contagious, and a family does not need to share meals.
Breastfeeding is generally not contagious to hepatitis B. The probability of detecting hepatitis B virus in breast milk is very low, and newborns have protective antibodies in their bodies after receiving hepatitis B vaccine and hepatitis B immunoglobulin. To date, it has not been proven that transmission can occur from a mother breastfeeding.
How should we prevent hepatitis B in our lives?
It is well known that vaccination against hepatitis B is the most effective means and method to prevent viral hepatitis B, but it should be done in groups.
1, newborns, if the parents of hepatitis B test are negative newborns, according to China’s 2010 slow hepatitis B guidelines, the newborn should be immediately after birth to receive the first shot of hepatitis B vaccine, the dose of 10ug 1, the first month to play the second shot, 10ug, 6 months later to play the third shot 10ug, a total of 3 shots. The injection site is inside the outer muscle of the front hip, (for example, if the first shot is given on January 1, the second shot should be given on February 1 and the third shot on July 1).
2.Infants and children, unimmunized people under 15 years old. 0, 1, 6 program for hepatitis B vaccination.
3.Family members of HBsAg positive people, especially spouses for surface antigen screening, negative people for the whole vaccination against hepatitis B. Three doses of 20ug each (within the middle muscle of the deltoid muscle of the upper arm, same for children and adults) can be given according to the 0, 1 and 6 months program, because they belong to the high-risk group.
4. Health care workers (including caregivers) and other high-risk groups should be vaccinated with hepatitis B vaccine throughout. A booster immunization (1 shot of 20 micrograms) should be administered after a negative surface antibody is found.
5.People who have frequent contact with blood, staff of childcare institutions, organ transplant patients, hemodialysis patients, frequent recipients of blood transfusion or blood products, people prone to trauma, people with multiple sexual partners, and people who inject drugs intravenously. For adults, 20 μg of hepatitis B vaccine is recommended.
6. For people with low immune function or non-responders, the vaccination dose (e.g. 60μg) and number of shots should be increased.
One month after the vaccination, you need to check the hepatitis B surface antibody at the hospital, if the hepatitis B antibody reaches a certain amount, you will not be infected with hepatitis B.
So how can mothers with hepatitis B carrier carry out the prevention of the next generation?
Clinically, it is common to see intra-family transmission, from grandmother to mother, and from mother to child. It is often sad to see this situation because, if the hepatitis B vaccination had been administered at the time of the child’s birth, hepatitis B would not have been transmitted. For newborns whose mothers are positive for hepatitis B surface antigen, immunization with hepatitis B vaccine combined with hepatitis B immunoglobulin is required. The first dose of hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine is recommended after birth, and the earlier the HBIG is given, the better, as early as possible within 24 hours after birth (preferably 12 hours after birth, at different sites); the dose of hepatitis B immunoglobulin should be ≥100 U and hepatitis B vaccine 10ug. The third dose of hepatitis B vaccine will be given at 6 months of age. Newborns can be breastfed by HBsAg-positive mothers after HBIG and hepatitis B vaccine are administered within 12 h of birth. With such vaccination, 90% of children are protected from hepatitis B infection.
However, 10% of children are still at risk of infection because they were infected in the mother’s womb, and this group of pregnant women often has a high viral load, with HBVDNA exceeding 106copies/ml. For this group, antiviral treatment should be started in the second 28 weeks of pregnancy for mother-to-child blockade. This is why pregnant women who are hepatitis B carriers are required to undergo liver function, HBVDNA and HBVM two-and-a-half tests.
Do I need to get vaccinated again if I have received hepatitis B vaccine before?
The protective effect of hepatitis B vaccination for those with antibody response generally lasts for at least 12 years, therefore, anti-HBs monitoring or booster immunization is not required for the general population. However, anti-HBs monitoring can be performed in high-risk groups, such as 1,8% of people with anti-HBs 38°C, which rarely causes Green-Barre syndrome (0,5/100,000).
Hepatitis B vaccine can be combined with any of the planned immunization products such as Tdap, BCG, measles, and polio vaccines, and no significant interfering effects have been observed.
What should I do in the unlikely event that I come into contact with blood with hepatitis B?
I often encounter patients who come to me for advice on this situation when I am out in the clinic. After accidental contact with the blood and body fluids of a hepatitis B patient, such as being pricked by a needle contaminated with HBsAg-positive blood or being splashed with HBsAg-positive blood into the conjunctiva of the eye or inputting HBsAg-positive blood, scalpel injury to the skin, etc., the following methods can be followed.
1.Serological testing HBV DNA, two-and-a-half pairs and liver function should be tested immediately and rechecked in 3 and 6 months.
2.Active and passive immunization If you have received hepatitis B vaccine and the amount of known anti-HBs is ≥10 mIU/mL, you may not have special treatment. If you have not received hepatitis B vaccine, or have received hepatitis B vaccine, but anti-HBs.