Hepatitis B Screening, Counseling and Education (HBSCE) Program
Need of family screening when someone in family has Hepatitis B Infection
1. Who in the family should be tested for Hepatitis B?
Spouse, parents (especially mother), and siblings need to be tested for Hepatitis B. If spouse, comes positive then children should also be screened.
Ideally anyone who lives with or is close to someone who has been diagnosed with Hepatitis B infection should get tested. Hepatitis B can be a serious illness, and the virus can be spread from an infected person to other family and household members, caregivers, and sexual partners.
2. What are the different viral markers that need to be tested during screening?
There are four viral markers that need to be tested: - HBsAg, Anti-HBc (Total), Anti-HBe and Anti-HBs. These tests help a doctor determine if a person has never been infected, has been infected and recovered, or is currently infected.
HBsAg tells about the active disease and individuals with HBsAg positive need evaluation and may need treatment. However Anti-HBc (Total) and Anti-HBe positivity indicates past infection. Anti-HBs point towards immunity against Hepatitis B infection.
3. Why is it important to get tested for Hepatitis B?
Testing sexual partners and household members of people with Hepatitis B helps determine what is needed to ensure their health. If a person has never infected with Hepatitis B, then the vaccine will protect them against the disease. However, if a person has been infected and recovered, they are immune to Hepatitis B and do not need the vaccine. For anyone who has chronic Hepatitis B, testing helps identify the disease early so they can benefit from medical care.
4. Can Hepatitis B be prevented? Who should be vaccinated against Hepatitis B?
Yes. The best way to prevent Hepatitis B is by getting vaccinated.
In India, under National Immunization Program, all infants should be given Hepatitis B vaccine (Birth dose followed by three doses at 6, 10 and 14 weeks). Vaccinating newborns can prevent them from getting the infection during birth or early childhood.
In addition, the vaccine is recommended for anyone who has never been infected and is at risk for getting Hepatitis B. This could include family members, caregivers, sexual partners, and others close to someone who has Hepatitis B. This includes 3 doses of vaccine (at 0, 1 and 6 months)
5. Is it possible to have been vaccinated against Hepatitis B but still be infected?
Yes. If someone was vaccinated as a child or adult and not as a newborn, it is possible that he or she got Hepatitis B from his or her mother before getting vaccinated. In this instance, a doctor will want to conduct a blood test to determine if they unknowingly became infected with Hepatitis B before vaccination.
6. How Hepatitis B spread?
Hepatitis B is usually spread when blood, semen, or other body fluids from a person with the Hepatitis B virus enter the body of someone who is not infected. The virus is very infectious and is transmitted easily through breaks in the skin or mucus membranes (nose, mouth, eyes and other soft tissues).
This can happen through:
- Sexual contact with an infected person
- Direct contact with infected or contaminated blood, even in tiny amounts too small to see
- Sharing personal items, such as toothbrushes, razors, syringes, or glucose monitors that have even microscopic amounts of blood on them
- Direct contact with open sores of an infected person
- An infected mother passing it to her baby at birth Hepatitis B is not spread through sneezing, coughing, hugging, or breastfeeding.
- Although the virus can be found in saliva, it is not believed to be spread through kissing or sharing utensils.
7. Diagnosis & treatment of Hepatitis B
Hepatitis B is diagnosed with specific blood tests that are not a part of routine blood investigations typically done during routine medical examination. Acute Hepatitis B infection should be suspected in a family through sexual spread or introduction of small amount of blood from infected family member into other members blood. Adequate nutrition, fluids, and close medical monitoring is advised, and if needed hospitalization. Most often it subsides. One needs to differentiate from reactivation of virus B, for which source of past transmission from infected mother or other family members needs to be investigated.
Those living with chronic Hepatitis B should be evaluated for liver problems and monitored on a regular basis. Even though a person may not have symptoms or feel sick, damage to the liver can still occur. Several new treatments are available that can significantly improve health and delay or reverse the effects of liver disease.
For further information, please contact:
Epidemiologist & Public Health Specialist,
Department of Clinical Research,
Institute of Liver and Biliary Sciences, New Delhi-110070
