Hepatitis B Virus, Thesis Paper Example

Thesis Statement: Although there is now a vaccine available to prevent the acquisition of the virus, it is important for individuals to keep in mind how HBV is able to be transmitted and take the necessary precautions in order to maintain an overall healthy lifestyle.

Search strategy and evaluation of resources:

The initial review of HBV was more focused on the background of the disease. I found information from a search pertaining to infection rates, ways of transmission, the physical structure of the virus, and the four stages of incubation for a person who becomes infected with the disease.

HBV has been cited as being a common cause of chronic liver disease and is reported to cause over one million deaths per year (Lin & Kirchner, 2004). This virus is capable of transmission by a person’s blood and body fluids, so the most common ways of acquiring the disease are through sexual intercourse or by using a contaminated needle. It has been described as being similar to the human immunodeficiency virus due to the way it is transmitted, but the hepatitis B virus is actually one hundred times more infectious than HIV and the chances of contracting it are much higher because it has the ability to remain alive outside of the body for over seven days (Lin & Kirchner, 2004). There is also a much higher acquisition rate of infection with patients who already have another chronic condition because their immune system is hindered and easily susceptible to any bacteria or viruses it may encounter (Lin & Kirchner, 2004).

HBV is part of the Hepadnaviridae family in the viral world and has a partially double-stranded circular DNA which makes up its genome. It is also surrounded by a core antigen and another surface antigen on the outer shell. This allows the virus to encode its own specific polymerase and also have a specific reverse transcriptase. However, in the overall scheme of viruses, the makeup is not terribly complex and mutations have not been nearly as troublesome as those with the HIV virus. This has caused the creation of a vaccine to be much easier (Lin & Kirchner, 2004).

Once a person is infected with HBV, there is a one to four month average incubation period before they begin to show any symptoms. Afterward, acute symptoms will begin to appear. Some of these are nausea, lack of appetite, tiredness, fever, and pain normally located in the upper right side of the abdomen. After the symptoms begin, they will normally go away within three months with treatment (Lin & Kirchner, 2004). The patient commonly will have a subsequent anemia and lymphocytosis for several months later as well as a slow decrease in the liver enzyme levels that will have risen during the main part of his infection (Lin & Kirchner, 2004).

There are actually four succinct stages of this disease. The first stage is referred to as the “immune tolerant” phase and has an increased amount of DNA replication as well as antigen and serum levels. It would be considered to the general population as the incubation period of the disease. The second phase is the “immune response” and is actually the process that begins to destroy the infected cells. This is when the disease is the most dangerous to the body as a whole.

Thirdly, there is the “inactive carrier” phase, which is basically the end of active replication of the disease and results in a negative antigen test for HBV. There may still be a very low level of DNA present in the body. Lastly, the patient will enter the “immune” stage and will have clearance of the antigen and an undetectable DNA with all likelihood of no reinfection (Lin & Kirchner, 2004).

I then researched information pertaining to the chronic infection of HBV and how this affects patients on a long-term basis versus the acutely acquired form of hepatitis. Factors used in this search pertained to medications and costs associated with the continued treatment of the disease as well as secondary conditions such as cirrhosis caused by the disease.

If a person contracts hepatitis B and is a carrier of the disease for longer than six months, he is said to have chronic hepatitis. This form of hepatitis can and will cause long-term damage as well as increased costs in medications to treat the disease. One problem that has developed during the recent past and encompasses the treatment of chronic hepatitis is the option of medications used to treat the disease and the costs incurred by patients. There have been issues with insurance companies not willing to pay for expensive treatments and the older treatment options not working as well as they did in the past. This is disheartening for those patients who have chronic HBV and are currently suffering from cirrhosis of the liver or liver failure as a direct result of this disease. Advocates have argued this is no different than any other chronic condition and insurance companies should pay for the medications that work, not simply the most inexpensive treatment options in the hopes there will be some stagnation in the progression of the HBV (Sherman, et al., 2007).

A problem with the medications and the validity used to prove their effectiveness lies in the testing methods before initial approval of human usage. Most of these medications are only tested for a limited time and the side effects and results are only recorded for a short period of weeks or maybe months. Sufferers of chronic HBV do not fall in this category and pharmaceutical companies have not been willing to test their medications on a more prolonged level. This has led to an impasse which has not helped the patient or their families in affordability of the medications (Sherman, et al., 2007).

The development of the hepatitis B vaccine has had a huge impact on our nation as well as the world. It led to a substantial decrease in the incidence of acute HBV thereby helping many individuals avoid the progression to chronic HBV. It is recommended for all children and adolescents to receive the vaccination as well as all health care workers and others who might come into contact with blood or body fluids from an infected person (Sherman, et al., 2007).

The HBV vaccination is actually a series of three injections that the patient receives usually over a two year time span and gradually causes antibodies to build up in the blood. Even women who are pregnant are advised to begin the vaccine due to the significance of the disease affecting the unborn child and the benefits outweighing the risks (Sherman, et al., 2007).

The hepatitis B vaccine was approved in the United States by the Food and Drug Administration in 1981 for general human use and was the first vaccine that successfully contained purified antibodies which were actually taken from the blood of those who were infected with HBV. The vaccine was named Heptavax B and was touted as the first of its kind. There was a subsequent media frenzy which followed, especially after many realized the groups studied were primarily homosexual populations and many of these individuals also were infected with the HIV virus simultaneously. It created a panic and widespread outrage which only fueled the media further (Conis, 2011).

Due to this, the science community began production of a second vaccine, this time one entirely different than the first. It was not derived from the blood of infected individuals; instead, was a genetically engineered vaccine that contained proteins specifically targeting the hepatitis B antigens. It was named Recombivax HB and has been deemed a success since its implementation in the late 1980s. As of the year 2000, there have been 47 states mandating all school aged children be vaccinated against the hepatitis B virus prior to attending school (Conis, 2011).

Because of this vaccine, there has been a substantial decrease in the number of new infections in the United States since 1985. Newborns are almost always vaccinated before being discharged from the hospital and scientists believe this implementation will eventually help new infections cease to exist altogether (Wilkins, Zimmerman, & Schade, 2010). This vaccination, accompanied by the strenuous testing every mother undergoes as part of her routine prenatal screening are two of the many steps that have been taken to stop this disease before it spreads to other individuals and mutates or becomes a costly problem to society (Wilkins, Zimmerman, & Schade, 2010).

As with the emergence of any new bacteria or virus, there is going to be a period of time when scientific evidence if being collected and testing must be performed to determine the best method of treatment and if options are available for various population groups. Fortunately, for hepatitis B, vaccination has been successful at decreasing the occurrence and spread of the disease in the United States as well as other developed countries who employ its use.

However, vaccination does not give individuals a free ticket to participate in risky behavior because there are other diseases in the environment we have yet to discover or find treatment options for. It is highly important to maintain a healthy lifestyle to ensure the least chance possible for contraction of any sexually transmitted or blood/body fluid transmissible disease. Proper care must be taken for the sake of ourselves as well as future generations in order to ensure the containment of these organisms and the prevention of potential problems in our society as a whole.

References

Conis, E. (2011). Do we really need Hepatitis B on the second day of life?: Vaccination mandates and shifting representations of Hepatitis B. J Med Humanit , 155-166.

Lin, K., & Kirchner, J. (2004). Hepatitis B. American Family Physician , 69 (1), 75-82.

Sherman, M., Shafran, S., Burak, K., Doucette, K., Wong, W., Girgrah, N., et al. (2007).

Management of chronic hepatitis B: Consensus guidelines. Canadian Journal of Gastroenterology , 21, 5C-21C.

Wilkins, T., Zimmerman, D., & Schade, R. (2010). Hepatitis B: Diagnosis and treatment. American Family Physician , 81 (8), 965-972.