Hepatitis is inflammation in the liver caused by specific viruses. The hepatitis viruses are referred to as types A, B, C, D and E. All types affect the liver, but they differ in illness severity and prevention options.

In the U.S., the most common forms are hepatitis A, hepatitis B and hepatitis C.

Acute or chronic hepatitis B

Hepatitis B is a serious disease caused by a virus that attacks the liver. It's one of the more common reasons for liver transplants in the U.S. Hepatitis B can be passed through blood, semen and other bodily fluids. Sneezing and coughing do not spread the virus.

For many people, hepatitis B is acute, or lasts less than six months. Acute infection may not need treatment and can be managed with rest, drinking plenty of fluids and monitoring of the infection.

For some people, however, hepatitis B can become chronic if it lasts more than six months. Chronic infection can go undiagnosed until symptoms of serious liver disease arise. Treatment for may include antiviral medications or a liver transplant if the liver is severely damaged.

When the hepatitis B virus becomes chronic, it can increase the risk of developing:

• Lifelong infection
• Cirrhosis, or scarring, of the liver
• Liver cancer
• Liver failure

The risk of the infection becoming chronic increases the younger people are when they are infected with hepatitis B, particularly newborns or children under 5.

Although there is no cure for hepatitis B, getting vaccinated is the best way to prevent it.

Hepatitis B vaccine

The hepatitis B vaccine usually is given as either a two-dose series spread out over one month or a three-dose series spread out over six months, depending on the vaccine used. Similar to the influenza vaccine, hepatitis B cannot be acquired from getting the vaccine.

The Advisory Committee on Immunization Practices (ACIP) updated the vaccine guidelines for hepatitis B.

The hepatitis B vaccine is recommended for:

• Newborns
• Children and adolescents not vaccinated at birth
• People who live with someone who has hepatitis B
• People with chronic liver disease or end-stage kidney disease
• Adults ages 19–59
• Adults, 60 and older, with or without known risk factors for hepatitis B infection

People who have not completed the vaccine series should contact their primary care provider to discuss the vaccine.

Avoid hepatitis B infection

The hepatitis B vaccine is the best way to prevent getting the virus. Other ways to reduce infection risk include:

• Ask about the hepatitis B status of any sexual partner.
  Use a new latex or polyurethane condom if the partner's health status is unknown. Condoms reduce the risk of contracting hepatitis B, but don't eliminate the risk.
• Don't use illegal drugs and never share needles.
• Be cautious about body piercing and tattooing.
  Ask how the equipment is cleaned, and ensure sterile needles are used.
• Ask about the hepatitis B vaccine before traveling.
  When visiting a region with high rates of hepatitis B, talk to a travel medicine specialist about the vaccine at least six months before traveling.

Victoria Louwagie is a physician assistant in Gastroenterology, and Jessica Sheehy is a physician assistant in Infectious Diseases, both in Mankato, Minnesota.

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