What is Hepatitis B?
Hepatitis refers to inflammation of the liver. Hepatitis B is a viral infection that causes liver disease. Infection ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis B can be either “acute” or “chronic.”
Acute hepatitis B virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the hepatitis B virus. Acute infection often clears but sometimes leads to a long term “chronic” infection where the hepatitis B virus persists.
The likelihood of the infection becoming chronic depends upon the age at which someone acquires hepatitis B. The younger a person is the greater his or her chance of developing chronic hepatitis B will be. Approximately 90% of infants with hepatitis B (who haven’t been vaccinated immediately after birth) will develop chronic infection if the mother has hepatitis B. Whereas, adults and children aged over 5 have a much lower risk chance (6%–10%) of developing chronic infection. Hepatitis B is 50–100 times more infectious than HIV.
Hepatitis B is usually passed from a person with acute or chronic hepatitis B to another person by
- Condomless penetrative anal or vaginal sex – this accounts for nearly two-thirds of adult acute Hepatitis B cases.
- Mothers can transmit to their baby.
- Injecting drugs whilst sharing injecting equipment (needles, syringes, spoons).
- Needlestick or sharps injuries in health care settings
- Sharing personal care items that may have come into contact with a person’s blood, such as razors or toothbrushes
How does it affect you?
Many people don’t know they have hepatitis B and/or may not have symptoms.
Seventy percent of adults will develop symptoms from the acute infection including: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, pale stools, joint pain and jaundice (yellow colour in the skin or eyes). On average symptoms appear 90 days (or 3 months) after exposure, but they can appear any time between 6 weeks and 6 months after acquiring the infection. Symptoms usually last a few weeks, but some people can be ill for as long as 6 months.
Some individuals with chronic infection have ongoing symptoms similar to acute hepatitis B, but most remain symptom free for as long as 20 or 30 years. About 15%–25% of people with chronic hepatitis B develop serious liver conditions, such as cirrhosis (severe scarring of the liver) or liver cancer. Despite the progressive inflammation and damage to the liver over time, some people still remain symptom free, although certain blood tests for liver function might begin to show some abnormalities.
Diagnosis
The types of hepatitis B tests commonly used identify whether you
- have acute or chronic (active) hepatitis B infection
- have recovered from infection i.e. cleared it and are naturally immune
- have not been exposed to the virus but are susceptible to it and thus could benefit from vaccination to prevent acquiring the virus after future exposure
- are immune to hepatitis B because you have been vaccinated
The tests SHL perform can indicate the first three scenarios. You will need to attend a clinic to test or confirm any vaccinated immunity.
Free Hepatitis B Test Kit
Get a free STI test kit delivered to your door. Take a self sample and return via freepost. Access your results online within a week. SHL.UK offers NHS funded home hepatitis B test kits for London.
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Management and treatment
If you have a reactive test result for hepatitis B the SHL Health Adviser team will refer you to a sexual health clinic that can offer ongoing hepatitis B management. They will first conduct blood tests to confirm the blood test performed by SHL.
People living with hepatitis B should be monitored and reviewed regularly by a hepatitis specialist. This may include regular blood tests, ultrasound scanning of the liver and an assessment for fibrosis using non-invasive methods such as a Fibroscan/Elastography (or for some individuals a liver biopsy).
Acute hepatitis B is usually a short-term infection where rest, a good diet and lots of water usually suffices.
Several medications have been approved for chronic hepatitis B treatment, and new drugs are in development. Your hepatitis specialist will advise you whether you require treatment.
Contacting partners
People with a new diagnosis of hepatitis B should inform previous sexual partners or partners whom you shared injectable equipment with. If you feel unable to inform previous partners one of our Health Advisers will be able to notify them on your behalf.
Previous sexual (or injecting) partners will be offered hepatitis B testing, considered for hepatitis B vaccination and/or possibly offered hepatitis B immunoglobulin if your last sexual/injectable contact with them was very recent. Hepatitis B vaccine is safe and effective and is usually given as 3-4 injections over a 6-month period.
The following individuals may also be considered for Hepatitis B vaccination
- People living with HIV or Hepatitis C
- Heterosexuals with a large number (10/year) of partners
- Gay, Bisexual or other men who have sex with men
- People who share needles, syringes, or other drug-injection equipment. This includes those who inject steroids and ‘recreational’ drugs
- Survivors of a recent sexual assault
- People or partners from hepatitis B endemic countries (outside of Western Europe, North America and Australasia)
- People with chronic liver disease or kidney disease
- People who have close household contact with someone living with hepatitis B virus
- Health care and public safety workers at risk for exposure to blood or blood-contaminated body fluids on the job
- Travelers to regions with moderate or high rates of hepatitis B
Maintain good sexual health
Once you recover from hepatitis B and have cleared it, you usually develop life-long immunity against future infection.
People living with hepatitis B should avoid alcohol because it can cause additional liver damage. You should also check before taking any prescription pills, supplements, or over-the-counter medications, as these can potentially affect the liver. You may be advised to have a Hepatitis A vaccination course and avoid donation of semen, organs or blood (even if you have cleared Hep B and become naturally immune to the virus).
People with a new diagnosis of Hepatitis B may also have acquired another STI. Therefore, we advise you have a full sexual health including chlamydia, gonorrhoea, syphilis, hepatitis C and HIV.
To prevent hepatitis B transmission use condoms for penetrative sex and do not share injecting equipment.
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