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Hepatitis B

What is hepatitis?

Hepatitis is inflammation of the liver. Inflammation is swelling that happens when tissues of the body are injured or infected. It can damage your liver. This swelling and damage can affect how well your liver functions.

What is hepatitis B?

Hepatitis B is a type of viral hepatitis. It can cause an acute (short-term) or chronic (long-term) infection. People with an acute infection usually get better on their own without treatment. Some people with chronic hepatitis B will need treatment.

Thanks to a vaccine, hepatitis B is not very common in the United States. It is more common in certain parts of the world, such as sub-Saharan Africa and parts of Asia.

What causes hepatitis B?

Hepatitis B is caused by the hepatitis B virus. The virus spreads through contact with blood, semen, or other body fluids from a person who has the virus.

Who is at risk for hepatitis B?

Anyone can get hepatitis B, but the risk is higher in:

  • Infants born to mothers who have hepatitis B
  • People who inject drugs or share needles, syringes, and other types of drug equipment
  • Sex partners of people with hepatitis B, especially if they are not using latex or polyurethane condoms during sex
  • Men who have sex with men
  • People who live with someone who has hepatitis B, especially if they use the same razor, toothbrush, or nail clippers
  • Health care and public-safety workers who are exposed to blood on the job
  • Hemodialysis patients
  • People who have lived in or traveled often to parts of the world where hepatitis B is common
  • People who have diabetes, hepatitis C, or HIV
What are the symptoms of hepatitis B?

Often, people with hepatitis B don't have symptoms. Adults and children over 5 are more likely to have symptoms than younger children.

Some people with acute hepatitis B have symptoms 2 to 5 months after infection. These symptoms can include:

  • Dark yellow urine
  • Diarrhea
  • Fatigue
  • Fever
  • Gray- or clay-colored stools
  • Joint pain
  • Loss of appetite
  • Nausea and/or vomiting
  • Abdominal pain
  • Yellowish eyes and skin, called jaundice

If you have chronic hepatitis B, you may not have symptoms until complications develop. This could be decades after you were infected. For this reason, hepatitis B screening is important, even if you have no symptoms. Screening means that you are tested for a disease even though you don't have symptoms. If you are at high risk, your health care provider may suggest screening.

What other problems can hepatitis B cause?

In rare cases, acute hepatitis B can cause liver failure.

Chronic hepatitis B can develop into a serious disease that causes long-term health problems such as cirrhosis (scarring of the liver), liver cancer, and liver failure.

If you have ever had hepatitis B, the virus may become active again, or reactivated, later in life. This could start to damage the liver and cause symptoms.

How is hepatitis B diagnosed?

To diagnose hepatitis B, your health care provider may use many tools to make a diagnosis:

  • A medical history, which includes asking about your symptoms
  • A physical exam
  • Blood tests, including tests for viral hepatitis
What are the treatments for hepatitis B?

If you have acute hepatitis B, you probably don't need treatment. Some people with chronic hepatitis B don't need treatment. But if you have a chronic infection and blood tests show that hepatitis B could be damaging your liver, you may need to take antiviral medicines.

Can hepatitis B be prevented?

The best way to prevent hepatitis B is to get the hepatitis B vaccine.

You can also reduce your chance of hepatitis B infection by:

  • Not sharing drug needles or other drug materials
  • Wearing gloves if you have to touch another person's blood or open sores
  • Making sure your tattoo artist or body piercer uses sterile tools
  • Not sharing personal items, such as toothbrushes, razors, or nail clippers
  • Using a latex condom during sex. If your or your partner is allergic to latex, you can use polyurethane condoms.

If you think you have been in contact with the hepatitis B virus, see your health care provider right away. Your provider may give you a dose of the hepatitis B vaccine to prevent infection. In some cases, your provider may also give you a medicine called hepatitis B immune globulin (HBIG). You need to get the vaccine and the HBIG (if needed) as soon as possible after coming into contact with the virus. It is best if you can get them within 24 hours.

National Institute of Diabetes and Digestive and Kidney Diseases

HIV in Women

What is HIV?

HIV stands for human immunodeficiency virus. It harms your immune system by destroying a type of white blood cell that helps your body fight infection. This puts you at risk for other infections and diseases.

How does HIV spread?

HIV can spread in different ways:

  • By having unprotected vaginal or anal sex with a person who has HIV. "Unprotected" means not using condoms or medicine to treat or prevent HIV. This is the most common way it spreads.
    • Anal sex is the riskiest type of sex for getting or spreading HIV. The rectum's lining is thin and may allow HIV to enter the body during anal sex.
    • During vaginal sex, HIV can enter the body through the delicate tissue that lines the vagina and cervix.
  • Rarely, through oral sex with a person who has HIV.
  • By sharing drug needles.
  • Through contact with the blood of a person who has HIV.
  • From mother to fetus during pregnancy.
  • From mother to baby during childbirth, or breastfeeding.
How does HIV affect women differently from men?

About one in four people in the United States who have HIV are women. Women who have HIV have some different problems than men:

  • Complications such as
    • Repeated vaginal yeast infections
    • Bacterial vaginosis
    • Severe pelvic inflammatory disease (PID)
    • A higher risk of cervical cancer
    • Menstrual cycle problems
    • A higher risk of osteoporosis
    • A higher risk of heart disease, especially heart attacks
    • Entering menopause younger or having more severe hot flashes
  • Different, sometimes more severe, side effects from the medicines that treat HIV
  • Drug interactions between some HIV medicines and hormonal birth control
  • The risk of giving HIV to their fetus while pregnant
  • The risk of giving HIV to their baby during childbirth or breastfeeding
Are there treatments for HIV?

There is no cure, but there are many medicines to treat both HIV infection and the infections and cancers that come with it. People who get early treatment can live longer and healthier lives.

HIV Medicines

What is HIV?

HIV stands for human immunodeficiency virus. It harms your immune system by destroying CD4 cells. These are a type of white blood cells that fight infection. The loss of these cells makes it hard for your body to fight off infections and certain HIV-related cancers.

Without treatment, HIV can gradually destroy the immune system and advance to AIDS. AIDS stands for acquired immunodeficiency syndrome. It is the final stage of infection with HIV. Not everyone with HIV develops AIDS.

What is antiretroviral therapy (ART)?

The treatment of HIV with medicines is called antiretroviral therapy (ART). It involves taking a combination of medicines every day. ART is recommended for everyone who has HIV. The medicines do not cure HIV infection, but help people with HIV live longer, healthier lives. They also reduce the risk of spreading the virus to others.

How do HIV medicines work?

HIV medicines reduce the amount of HIV (viral load) in your body, which helps by:

  • Giving your immune system a chance to recover. Even though there is still some HIV in your body, your immune system should be strong enough to fight off infections and certain HIV-related cancers.
  • Reducing the risk that you will spread HIV to others.
What are the types of HIV medicines?

There are many different types (called classes) of HIV medicines. Some work by blocking or changing enzymes that HIV needs to make copies of itself. This prevents HIV from copying itself, which reduces the amount of HIV in the body. Several types of medicines do this:

  • Nucleoside reverse transcriptase inhibitors (NRTIs) block an enzyme called reverse transcriptase
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs) bind to and later change reverse transcriptase
  • Integrase inhibitors, also called integrase strand transfer inhibitors (INSTIs), block an enzyme called integrase
  • Protease inhibitors (PIs) block an enzyme called protease

Some types of HIV medicines interfere with HIV's ability to infect CD4 immune system cells:

  • Fusion inhibitors block HIV from entering the cells
  • CCR5 antagonists and post-attachment inhibitors block different molecules on the CD4 cells. To infect a cell, HIV has to bind to two types of molecules on the cell's surface. Blocking either of these molecules prevents HIV from entering the cells.
  • Attachment inhibitors bind to a specific protein on the outer surface of HIV. This prevents HIV from entering the cell.

Pharmacokinetic enhancers are another type of medicine. They are sometimes taken along with certain other HIV medicines. Pharmacokinetic enhancers increase the effectiveness of the other medicine. They work by slowing the breakdown of the other medicine. This allows that medicine to stay in the body longer at a higher concentration.

There are also multidrug combinations, which include a combination of two or more different types of HIV medicines.

When do I need to start taking HIV medicines?

It's important to start taking HIV medicines as soon as possible after your diagnosis, especially if you:

  • Are pregnant
  • Have AIDS
  • Have certain HIV-related illnesses and infections
  • Have an early HIV infection (the first 6 months after infection with HIV)
What else do I need to know about taking HIV medicines?

You and your health care provider will work together to come up with a personal treatment plan. This plan will be based on many factors, including:

  • The possible side effects of HIV medicines
  • Potential drug interactions with any other medicines you take
  • How many medicines you will need to take every day
  • Any other health problems you may have

It's important to take your medicines every day, according to the instructions from your provider. If you miss doses or don't follow a regular schedule, your treatment may not work, and the HIV virus may become resistant to the medicines.

HIV medicines can cause side effects. Most of these side effects are manageable, but a few can be serious. Tell your provider about any side effects that you are having. Don't stop taking your medicine without first talking to your provider. There may be steps you can take to help manage the side effects. In some cases, your provider may decide to change your medicines.

What are HIV PrEP and PEP medicines?

HIV medicines are not just used for treatment. Some people take them to prevent HIV. PrEP (pre-exposure prophylaxis) is for people who don't already have HIV but are at very high risk of getting it. PEP (post-exposure prophylaxis) is for people who have possibly been exposed to HIV.

NIH: Office of AIDS Research

Intestinal Obstruction

An intestinal obstruction occurs when food or stool cannot move through the intestines. The obstruction can be complete or partial. There are many causes. The most common are adhesions, hernias, cancers, and certain medicines.

Symptoms include:

  • Severe abdominal pain or cramping
  • Vomiting
  • Bloating
  • Loud bowel sounds
  • Swelling of the abdomen
  • Inability to pass gas
  • Constipation

A complete intestinal obstruction is a medical emergency. It often requires surgery.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Itching

What is itching?

Itching is an irritating sensation that makes you want to scratch your skin. Sometimes it can feel like pain, but it is different. Often, you feel itchy in one area in your body, but sometimes you may feel itching all over. Along with the itching, you may also have a rash or hives.

What causes itching?

Itching is a symptom of many health conditions. Some common causes are:

  • Allergic reactions to food, insect bites, pollen, and medicines
  • Skin conditions such as eczema, psoriasis, and dry skin
  • Irritating chemicals, cosmetics, and other substances
  • Parasites such as pinworms, scabies, head and body lice
  • Pregnancy
  • Liver, kidney, or thyroid diseases
  • Certain cancers or cancer treatments
  • Diseases that can affect the nervous system, such as diabetes and shingles
What are the treatments for itching?

Most itching is not serious. To feel better, you could try:

  • Applying cold compresses
  • Using moisturizing lotions
  • Taking lukewarm or oatmeal baths
  • Using over-the-counter hydrocortisone cream or antihistamines
  • Avoiding scratching, wearing irritating fabrics, and exposure to high heat and humidity

Contact your health care provider if your itching is severe, does not go away after a few weeks, or does not have an apparent cause. You may need other treatments, such as medicines or light therapy. If you have an underlying disease that is causing the itching, treating that disease may help.

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