Hepatitis B stays active in some people for life


DEAR DR. DONOHUE: I would like to know the course, prevention and treatment of hepatitis B. Is this illness active inside the human body for life? — M.M.

ANSWER: Hepatitis B is an enormous worldwide problem with approximately 400 million humans infected with this virus. Half a million people die from it yearly. In the United States, about 1.25 million people carry the virus.

The initial infection with the virus has signs and symptoms that are similar to all causes of hepatitis (liver inflammation): nausea, vomiting, fatigue, headache, temperature elevation and a yellowing of the skin and whites of the eyes. However — and this is an important piece of information — many infected patients develop no signs and symptoms, and never realize that they have been infected. Later in life, they are told they have been infected with the virus because of abnormal lab tests.

The hepatitis B virus stays for life in the liver of 10 percent to 15 percent of those it infects. Some of these people eventually will develop liver cirrhosis or liver cancer.

Treatment is available. If patients have ongoing liver damage and if the virus is detected in their blood as well as in their liver, these people are in need of antiviral drugs. Seven such drugs are obtainable. There definitely is help for the chronically infected hepatitis B patient.

Prevention in the form of a vaccine is possible. All infants now receive the hepatitis B vaccine. Since the vaccine has been in wide use, a 90 percent drop in the infection rate has occurred in the U.S. Adults who have missed out on childhood vaccination should be vaccinated if they are at high risk of catching this illness. Having many sexual partners, men who have sex with men, needle-using drug users, sexual partners of an infected person and health-care workers are considered to be at risk and should get the vaccine.

The booklet on hepatitis explains the A, B and C infections. Readers can obtain a copy by writing: Dr. Donohue — No. 503, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Three years ago, at the age of 14, my granddaughter had Stevens-Johnson syndrome. She broke out in blisters all over her throat and lips. She was rushed to the children’s hospital and was admitted to intensive care. Please advise me of this illness and what precautions my granddaughter should take. — H.H.

ANSWER: Thankfully, Stevens-Johnson syndrome is a rare occurrence. It’s a reaction mostly to drugs like penicillin, erythromycin, quinolone antibiotics, sulfa, some epilepsy drugs and even the nonsteroidal anti-inflammatory drugs that everyone takes — Advil, Aleve and Motrin. Less often, an infection triggers an outbreak.

Purple spots cover the face and trunk, and they fuse into patches that eventually become blisters. The involved skin sheds. Ulcers appear in the mouth and on the eyes. The liver, kidney and lungs can be affected. Treatment is carried out in a burn unit or an intensive-care unit.

Your granddaughter must, as I am sure her doctors emphasized, avoid a repeat exposure to the culprit drug. She should wear a bracelet warning everyone not to give her that drug. It sounds like she weathered the storm well.

DEAR DR. DONOHUE: I have read various articles concerning the danger of cooking with aluminum cookware. What is your opinion on this matter? — G.B.

ANSWER: Let me give you the opinion of experts.

The World Health Organization, the Environmental Protection Agency and the National Institutes of Health all say that aluminum cookware is safe.

It releases very little — insignificant — amounts of aluminum into foods.

I don’t hesitate to eat food cooks in aluminum pots or pans.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.