Hepatitis, which is an important liver disease, is one of the most important health problems in the world today. Although its incidence has decreased in our country in recent years, hepatitis B in particular still maintains its importance. The possibility of developing important diseases such as cirrhosis in some of the patients with hepatitis increases the importance of the disease even more.
Hepatitis A, Hepatitis B and Hepatitis C viruses take the first place among the factors that cause hepatitis. Hepatitis A virus causes only acute hepatitis. There is no chronicity or carriage in them. Hepatitis B and C viruses can cause both acute and chronic hepatitis. However, not all people who get B and C viruses have the disease. While some of the people who get these viruses in various ways have liver damage and accordingly elevations in liver enzymes in the blood, most of them are only carriers. While the carrier rate in our country is below 1% for the C virus, it varies between 5 and 10% according to the regions for the B virus. Individuals who are healthy carriers continue their lives normally in the society like everyone else. However, it is recommended that carriers not drink alcohol, avoid drugs that are harmful to the liver, and go to a specialist once a year to have their liver checked.
Since people with hepatitis B virus (HBV) may be carriers as well as the disease, the transmission routes should be well known.
The transmission routes of HBV are widely known today. This virus has been detected in almost all body fluids, especially blood. However, in practice, it is accepted that HBV is transmitted through blood, blood products and sexual contact. Contamination with other body fluids has not been demonstrated.
Main Modes of Transmission in HBV:
- Contact with blood and blood products and blood transfusions
- HBV-contaminated needle, syringe, scalpel , contamination with catheters and surgical instruments,
- HBV-infected and poorly disinfected hemodialysis devices,
- Tooth extraction and filling with poorly cleaned instruments,
- Intravenous drug use,
- Acupuncture and tattooing with tools that have been in contact with microbes and not cleaned well, ear piercing, shaving with a razor blade of an HBV positive person and brushing with a toothbrush,
- Especially to the child born to a surrogate mother with HBeAg positive transmission during birth,
- Transmission from HBV positive person to healthy person due to skin wound, cut, mucous injury and contact with blood,
- Sexual transmission
HBV transmission of your ways Some individuals and/or groups are at risk due to its characteristics. In general, it is recommended that people with a high probability of HBV transmission be vaccinated first, then gradually and within the framework of a plan, vaccinating other people as well. The groups that constitute the high risk group for HBV and should be vaccinated primarily are:
- Surgeons, dentists and all other health personnel, especially laboratory and blood center workers,
- HBV carriers Transmission from mothers to children can occur during or after birth. Therefore, all children and newborn babies of mothers who are sick or carriers,
- Sexual transmission is the second most important mode of transmission of HBV after blood-borne transmission. For this reason, spouses of individuals with hepatitis or HBV carriers,
- If there is hepatitis or HBV carrier in the family, all other family members and people they are in close relationship with,
- Homosexuals, people who have intravenous drug habits and general housewives. These are risky groups in which HBV is found at a high rate. These should also be vaccinated.
- Those with chronic kidney disease (especially hemodialysis patients),
- Patients with immunodeficiency,
- Crowded living conditions, poor hygiene and low socioeconomic status increase the rate of HBV transmission. . For this reason, those who live in places such as orphanages, nursing homes, prisons and kindergartens where people are together collectively and where many materials are used in common,
- Those who have frequent blood and blood products transfusions, especially those with hemophilia, or who are dependent on hospitals, Hematology and oncology patients who have frequent injections and frequent percutaneous interventions, other chronic patients,
- Since the HBV carrier rate is high in our society and the immune systems of newborn babies are not developed enough yet, all newborn babies are at risk and should be vaccinated.
Today, only antiserum and vaccine have been developed against HBV. In many countries of the world, vaccination programs are applied to individuals, primarily those at risk. Only people with negative HBsAg and Anti-HBs results in blood tests are vaccinated.
Passive immunity can be provided to persons suspected of contact with HBV by administering HBV specific immune globulin within the first 72 hours. Active immunity can be made with any of the four different hepatitis B vaccines available in our country. The protection provided by vaccination is over 90% in all vaccine types.
Vaccinations should be given on time, in accordance with the recommended schedule. At the earliest 6-8 weeks after three doses of vaccination, it should be checked whether the vaccine is effective or not. In general, it is recommended to check the antibody (Anti-Hbs) level 12 months after the last vaccine dose, and to give a single dose of vaccine in addition to those with low levels. Afterwards, a single dose of vaccine should be administered, if necessary, to check the antibody level and to increase the protection of the vaccine every 4-5 years on average.
