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The B hepatitis, his prevention and his treatment cause a lot of questions: How the trap one? Is it necessary to vaccinate itself? Does the B hepatitis become necessarily chronic? Are the treatments efficient?... Of the transmission to the treatment, discover the answers to your questions.  1. Is the B hepatitis frequents?  Yes, the infection is frequent, even though a big majority of the infected patients will heal quickly, without passage to the chronicity. About 2 billions of people in the world would be infected by the virus of the B hepatitis, of which 350 millions suffering of a hepatitis B chronique1. In France, about 280 000 people present a hepatitis B chronique2. 2. How does one catch the virus of the B hepatitis? The virus of the B hepatitis, very infectious, transmits itself mainly by blood and the sexual secretions, but also by the maternal milk. Consequently, to be contaminated by this virus, it is necessary to have a contact with secretions or the infected blood: non protected sexual intercourse with a person bearer, sharing of needles or syringes contaminated, tattoos or piercings done in bad conditions of hygiene, contaminated domestic material use (toothbrush, razor, nail clippers, buckles of ears, covered..). The jobs in contact with blood (personal of health for example) are more to risk. 3. How to avoid the contamination?  The best means to warn the infection are the vaccination. Beyond, the prevention rests on the loop line of blood and the sexual secretions: avoid to share your personal effects, assure yourselves the use of sterile needles for a possible tattoo or piercing (or of a clean razor at the hairdresser), use some condoms at the time of your sexual intercourse and of course, in case of addiction, don't share your needles. In case of pregnancy, there is a transmission risk to the newborn, what explains that the virus is systematically sought-after at the pregnant women, in order to put an immediate treatment of the newborn so necessary in place (injection of antibody and vaccine). 4. What are the symptoms of the B hepatitis?  This illness rarely gives some symptoms when it is sharp. Nevertheless the infection can give the signs looking like a flu initially (fever, muscular and articular pains), then a big general fatigue appears, with a possible jaundice ("ictère", yellow color of skin, with dark urines, clearer stools). These signs disappear then progressively (in 2 to 6 weeks), hepatitis sharp viral B evolving then either toward the recovery, either toward the chronicity. In very rare cases, hepatitis sharp B is said fulminating, with neurological attack and risk of coma, of death. 5. How to know if I have the B hepatitis? In the absence of reminiscent symptoms (most frequent case), the diagnosis is made thanks to a simple analysis of blood, done for example on the occasion of a balance of health (research of an increase of the transaminases, enzymes reflecting the state of the liver, specific research of controlled antibodies against the B virus, research of antigens of the virus). 6. How does this illness evolve in the time?  In more of 90% of the cases, the virus eliminates itself naturally after the infection, without passage to the chronicity. In 5 to 10% of the cases, he doesn't eliminate himself, the patient becomes then what one calls "chronic carrier." Among these patients, a majority won't present worries of health. For a minority, this chronic portage is going to evolve especially toward a hepatitis chronic B, with the risk to present a cirrhosis or a cancer of the liver then, in the absence of surveillance and specific treatment. 7. What is the present treatment of the B hepatitis? To the sharp stage (fever, pains, jaundice or fatigue possible) and in the absence of gravity signs, there is not a specific treatment, except rest and the stop of the consumption of alcohol or non indispensable medicines (that can damage the liver more). To the chronic stage, the objective of the prescribed treatment will be to limit the multiplication of the virus of the B hepatitis in the organism. For it, the physicians have the interféron, a medicine that blocks the virus and stimulate immunity, managed once per week in injection. They also have henceforth antiviraux of new generation, more efficient treatments against the chronic infection. These antiviraux is rather tolerated well and takes themselves by the mouth (not of necessary weekly sting). 8. Are these treatments efficient?  Today, the use of the interféron and medicines antiviraux on long lengths permits to consolidate the clinical state of two patients on three about, avoiding the intervening of serious complications. These treatments improve regularly, making hope in years to come for a supplementary mastery of this chronic illness and therefore a least resorts to the transplantation of the liver (ultimate solution in case of major chronic destruction of this organ). 9. Does a vaccine exist against the B hepatitis?  Yes, a protective vaccine and tolerated well is marketed. The doubts of the years 90 on a possible starting point of multiple sclerosis following the administration of the vaccine have since been raised by the French scientists, who demonstrated the absence of association between the vaccination and the intervening of this illness as studying 143 children having developed a SEP between 1994 and 20033. On the contrary, the preventive vaccination should allow term to decrease the intervening of hepatitises chronic B and of death. 10. Is it advisable to make themselves vaccinate?  If yes, to what age? The vaccination against the B hepatitis is part of the vaccinal calendar defined by the High Council of Public Health. He is recommended to practice it systematically since the age of 2 months and before the age of 13 years, while privileging the vaccination of the infant as well as the vaccination of people to risk (personal of health notamment)4. He is also recommended to make vaccinate the children who yet were not.                                                                                                     2008-12-06
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