Detailed description of the study
Hepatitis B is a disease caused by a DNA virus from the Hepadnaviridae family. The virus is widespread and is one of the most common causes of chronic liver diseases.
Hepatitis B infection occurs through contact with blood, and less often with other biological fluids. The virus enters the body when the integrity of the skin and mucous membranes is damaged during injections or medical manipulations with contaminated instruments. Health care workers who come into contact with blood are at increased risk of hepatitis B infection.
However, transmission of the hepatitis B virus through contact and household contact is possible in families where one of the people is a carrier of the infection. Infection is caused by the use of common hygiene items - razors, washcloths.
Sexual transmission is also one of the most common. In some countries, it leads among other epidemiological mechanisms. The hepatitis B virus is included by the World Health Organization in the list of sexually transmitted diseases. It is possible that a child may be infected with it during childbirth from an infected mother, as well as during breastfeeding. Cases of transmission of the virus through the placenta have been described.
Penetrating the body through the bloodstream, the virus enters the liver, where it attaches to the membrane of liver cells (hepatocytes). Its attachment to the surface of the hepatocyte is ensured by a protein called HBs antigen. The virus then penetrates the cell and multiplies within it. At the same time, the immune system produces antibodies aimed at attacking viral particles - antigens. This is how anti-HBs antibodies are formed.
Hepatitis B in most cases occurs in an acute form (90-95%) and ends with recovery. During the acute period, the virus multiplies in the liver, some people experience malaise, symptoms similar to a cold, sometimes accompanied by jaundice. As a result, persistent immunity to the infection is developed, which is assessed by the presence of anti-HBs antibodies.
Currently, vaccination against the hepatitis B virus is widely available. It allows you to form immunity against the pathogen for a period of up to 10 years. The immune response to vaccination against this virus is also assessed by the presence of a sufficient titer of anti-HBs antibodies.
No hepatitis!
The World Health Organization has set an ambitious goal of achieving the complete elimination of viral hepatitis in just one decade. First of all, of course, we are talking about hepatitis B and C, as the most dangerous. But while victory over them has not yet been achieved, we ourselves must take care of our own safety.
The danger is posed not so much by obvious, acute hepatitis B and C, but by their chronic forms, which occur covertly. They increase the risk of developing cirrhosis and liver cancer over time. Today, these diseases affect approximately 325 million people in the world. In our country, according to official statistics, there are from 3 to 5 million people, but in reality the numbers are apparently higher, since many do not even realize that they are sick.
Our blood enemy
It’s not for nothing that the hepatitis virus is called the “gentle killer” - after all, until it thoroughly destroys the liver, it does not manifest itself. And often its markers are discovered by chance, for example, when taking tests for hospitalization and undergoing planned surgery.
Many people have received hepatitis C through dialysis and blood transfusions. Unfortunately, donors began to be tested for this virus not so long ago. Even today, despite all precautions, it is impossible to completely eliminate the risk of infection during surgical operations, as well as during dental treatment or during cosmetic procedures associated with skin damage - manicure, pedicure, tattooing.
It is also not difficult to become infected with hepatitis B (after all, this virus is 50 times more contagious than HIV) - it is enough only for damaged mucous membranes or skin to come into contact with any infected biological fluid of a sick person.
Is revaccination necessary?
There is no vaccine for hepatitis C because the virus is highly variable. Therefore, you can only protect yourself from it by following all precautionary rules and regularly getting tested. Once a year, blood tests for hepatitis are not only advisable, but necessary, since there are many ways of infection. But it is especially important to take such tests after any invasive interventions (both medical and cosmetic) and, of course, after unprotected sexual intercourse. The sooner a disease is detected, the easier it will be to treat it, and the lower the risk of becoming a source of infection for other people. By the way, you need to be tested for hepatitis both before hospitalization and 3-4 months after surgical treatment.
But there is an effective vaccine against hepatitis B. But since after 5-7 years the titer of protective antibodies to the virus decreases even in the blood of vaccinated people, revaccination may become necessary. In addition, immunity is not developed if the vaccination was done incorrectly.
A special blood test for antibodies to the surface antigen of the hepatitis B virus (Anti-HBs) will help to find out how effective immunity has been formed during vaccination against hepatitis B and whether revaccination is needed. You need to take the test 2-3 months after completing the vaccination cycle. In this case, it is possible to understand whether a protective level of antibodies has been accumulated after vaccination. An antibody titer of less than 10 mIU/ml indicates the absence of an immune response to hepatitis B vaccination (in this case, the vaccination must be repeated as soon as possible after consultation with a doctor).
If a person is sick with hepatitis B, then the same as after vaccination, antibodies appear in the person’s blood when he is in the recovery phase from acute hepatitis B. This happens after the surface antigen of the hepatitis B virus, HBsAg, disappears in the blood. is the main screening marker for hepatitis B. You can distinguish a vaccinated person from someone who has had hepatitis using a laboratory test - antibodies to the nuclear (cor) antigen of hepatitis B. This marker will be positive in those who have had the disease, but just in a healthy person after vaccination it will not be detected.
Why is the virus dangerous?
Hepatitis B is a disease caused by the HBV virus. The virus has a pronounced hepatotropic effect, that is, when it enters the body, it destroys the main cells of the liver - hepatocytes. Due to extensive damage, the organ ceases to perform its functions, which affects the general condition, leads to intoxication, and metabolic disorders. Acute infection may be accompanied by jaundice, mild malaise, or be asymptomatic. Often the disease remains undiagnosed or is detected accidentally.
The clinical picture of the disease is explained by the destruction of liver cells and impaired bile outflow. Due to the accumulation of toxins, the entire body suffers, primarily poisoning affects the cells of the nervous system.
- After the acute phase, the virus either dies or the disease becomes chronic. If the virus dies, a strong immunity is formed in the body, liver cells are restored over time, and the functions of the organ are normalized.
- As hepatitis becomes chronic, hepatocytes are gradually replaced by connective tissue cells, which leads to fibrosis, cirrhosis and organ failure. In some cases, liver cancer develops. The chronic form is characterized by periodic exacerbations.
The development of chronic hepatitis B occurs in 95% of infected newborns; in adults, the proportion of pathology that becomes chronic is 5%. It is for this reason that neglecting vaccinations is dangerous. The first must be done within the walls of the maternity hospital, further revaccinations are carried out according to the approved vaccination schedule.
Vaccine composition
At the Professor Gorbakov Clinic, the drug “Combiotech” is used for vaccination of children under 19 years of age in a dosage of 5 ml. It includes:
- shell fragments, or surface antigen of the virus, to which the body produces antibodies, forming an immune response (10 μg);
- aluminum hydroxide is an adjuvant substance that enhances the production of antibodies;
- preservative thiomersal.
In Russia, it is allowed to use several types of vaccines against hepatitis B, which are interchangeable (Engerix B, Regevak B, Infanrix Hexa, etc.). If you started the course with one drug, you can always continue it with another - the result of vaccination will not change.
Vaccination against hepatitis B at the Gorbakov Clinic
Doctors at Professor Gorbakov’s Clinic are well acquainted with the vaccination schedule and know how to act if it is violated. If timing allows, we will give you or your child the remaining vaccinations to develop lasting immunity to the disease. If the rules are not followed, we will check the level of antibody concentration in the blood, and based on the results of the check, we will recommend starting the schedule “from scratch” or continuing vaccination. All vaccinations are done after the patient has been examined by a specialist, and in some cases after laboratory tests.
You can trust us:
- According to statistics, after carrying out a full vaccination regimen in our Clinic, immunity is developed in 99% of patients.
- For children under three years of age, we inject the drug into the upper third of the thigh intramuscularly, where at this age the densest layer of muscle tissue is observed. For children over three years of age and adults - in the area of the deltoid muscle on the shoulder.
- Mild allergic reactions in the form of redness occur very rarely and disappear after 2-3 days.
- There were no post-vaccination complications in our clinical practice.
If you are in a risk group - for example, if you come into contact with blood products, we recommend getting vaccinated against hepatitis B at least every 5 years. At Professor Gorbakov’s Clinic, this vaccination is given to both adults and children - after examination by a doctor and analysis of the previous vaccination schedule. Our doctors approach each case individually, answer all questions and work only with proven drugs.
Don’t risk your health and that of your children, especially since protecting yourself from the dangerous viral disease hepatitis B is so easy today!
Hepatitis B vaccination schedule
In the absence of contraindications, a healthy child is vaccinated according to the following scheme:
- within the first 24 hours after birth;
- at 1 month;
- in six months.
If the baby is at risk, the second dose of the vaccine is administered at one month, the third at two months, and a fourth dose is recommended at one year. If for some reason the newborn was not vaccinated on the first day, the vaccination must be done before he reaches one month of age, the second - up to four months, and the third - in the interval from four months to one and a half years.
Vaccination against hepatitis B is also carried out for adults under 55 years of age, as well as for adolescents. In this case, the following scheme applies: the second vaccination is a month after the first, and the third is five months after the second.
Contraindications and consequences
Contraindications to the administration of the vaccine are:
- pregnancy and lactation;
- exacerbation of chronic diseases or acute conditions due to infection or other diseases.
- allergic reaction to the vaccine.
Most patients tolerate the hepatitis B vaccine without side effects, but in some cases the following may occur:
- fever, general weakness, dizziness;
- reaction at the injection site: pain, redness, itching, lump formation.
In isolated cases, an acute reaction to the vaccine occurs, which can be expressed as:
- pain in joints and muscles;
- nausea, diarrhea, vomiting, intestinal pain;
- convulsions, inflammation of peripheral nerves;
- enlarged lymph nodes.
Prevention measures
The infection is transmitted sexually and hematogenously (with blood). The hepatitis B virus can persist for quite a long time (up to several weeks) in particles of dried blood - on a razor blade, needle point, etc. The virus is not killed by boiling and can withstand repeated freezing and thawing.
- The most effective preventive measure against hepatitis B is vaccination. Vaccination prevents both types of infection and creates a lasting immune response.
- To prevent infection from mother to child during childbirth and pregnancy, women are prescribed a course of tenofovir, an antiviral drug that reduces the risk of transmission of infection during childbirth.
- To prevent infection through blood in the home, it is recommended to use only personal hygiene products, razors, and manicure tools. Scratches and cuts on the skin must be immediately treated with an antiseptic and covered with a band-aid. When performing manipulations where contact with an infected person is possible, rubber gloves are used.
- Using condoms reduces the risk of sexual transmission of the virus.
