Hepatitis B

What is it?

Hepatitis refers to inflammation of the liver. Hepatitis B is a contagious 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 can, but not always, leads to a long term “chronic” infection where the hepatitis B virus remains in a person’s body.

The likelihood of the infection becoming chronic depends upon the age at which someone becomes infected. The younger a person is the greater his or her chance of developing chronic hepatitis B will be. Approximately 90% of infected infants will develop chronic infection. Whereas, adults and children aged over 5 have a much lower risk 6%–10% of developing chronic infection. Hepatitis B is 50–100 times more infectious than HIV

Hepatitis B is usually passed from person to person by

  • Unprotected penetrative anal or vaginal sex with a Hepatitis B infected partner – this accounts for nearly two-thirds of adult acute Hepatitis B cases.
  • An infected mother to her baby
  • Injecting drugs whilst sharing injecting equipment (needles, syringes, spoons) that has been used by someone infected with Hepatitis B.
  • Needlestick or sharps injuries in health care settings
  • Sharing personal care items that may have come into contact with a hepatitis B infected person’s blood, such as razors or toothbrushes

How does it affect you?

Many people don’t know they are infected 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 being infected. 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 (scarring of the liver) or liver cancer. Even as the liver becomes diseased, some people still do not have symptoms, 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

  • are actively infected (acute or chronic)
  • have recovered from infection i.e. cleared it and are naturally immune
  • have not been infected but are susceptible to it and thus could benefit from vaccination to prevent being infected with the virus
  • 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.

Treatment

People with hepatitis B should be monitored and reviewed regularly by a Hepatitis specialist for signs of liver damage and evaluated for possible treatment. If you test positive for Hepatitis B at SHL our Health Adviser team will refer you to a clinic or service that has expertise in managing hepatitis B.

There is no medication available to treat acute hepatitis B. During this short-term infection, rest, a good diet and lots of water / fluids, usually suffice.

Several medications have been approved for chronic hepatitis B treatment, and new drugs are in development. However, not every person with chronic Hepatitis B needs to be on medication, and the drugs may cause side effects in some patients. Your specialist will advise you.

Contacting partners

If you are diagnosed with hepatitis B you will need to inform previous sexual partners or partners whom you shared injectable equipment with as they may also be infected. If you feel unable to inform previous partners one of our Health Advisers will be able to notify them on your behalf.

Previous sexual 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 shots over a 6-month period.

The following individuals may also be considered for Hepatitis B vaccination

  • People infected with HIV or Hepatitis C
  • Heterosexuals with a large number (10/year) of partners
  • Bisexual men / 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 infected with the 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 develop antibodies that protect you from the virus usually for life. An antibody is a substance found in the blood that the body produces in response to a virus. Antibodies protect the body from disease by attaching to the virus and destroying it.

If you are infected with hepatitis B  you 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 damage the liver as well. You should have Hepatitis A vaccinations and avoid donation of semen, organs or blood (even if you have cleared Hep B and become naturally immune to the virus).

If you have been infected with Hepatitis B it is possible you may also have been infected with another STI: any STI if you became Hep B infected by sex and/or hepatitis C and HIV if you were infected from sharing injecting equipment. 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.