- Hepatitis B is a virus found in infected blood, semen (cum) and vaginal fluids.
- It’s a sexually transmitted infection (STI) that can be passed on through unprotected sex. You can also get it from contaminated needles and syringes. It’s also commonly passed on from a mother to her baby during birth.
- There is a vaccine to prevent hepatitis B, which is routinely offered to infants as well as at-risk groups.
- You can prevent hepatitis B by practising safer sex, never sharing needles and syringes, and avoiding unlicensed tattoo parlours and acupuncturists.
- Most people don’t need treatment for acute hepatitis B. If the infection becomes chronic, there is no cure, but it can be managed with treatment.
What is hepatitis B?
Hepatitis B (also known as hep B or HBV) is part of a group of hepatitis viruses that attack the liver. It can be passed on via unprotected sex (sex without a condom or dental dam), through contaminated needles and from a pregnant woman to her baby during birth.
You may be more at risk of getting hepatitis B if you inject drugs, are a sex worker, are a man who has sex with men, change partners frequently, are in close contact with someone who has chronic hepatitis B, or your occupation exposes you to the virus, for example, a nurse.
Vaccines for hepatitis B are routinely offered to infants. Adults at a higher risk of getting hepatitis B may also be offered the vaccine.
Hepatitis B does not always cause symptoms and can pass in a few months without treatment (acute infection). People can also have a lifelong infection (chronic), and without appropriate treatment and care, it can become more serious and lead to liver damage or death.
How do you get and prevent hepatitis B?
Hepatitis B infection can happen when the blood, semen or vaginal fluids of an infected person gets into someone else’s body. It’s really infectious and can last outside the body for up to seven days.
Hepatitis B can be passed on via unprotected sex – including vaginal, anal and oral sex and other sexual activities – with someone who has hepatitis B, even if they don’t have symptoms.
Some sexual activities are risker than others, such as anal sex or any type of sex where blood may be present.
You can prevent hepatitis B by:
- Knowing the status of any sexual partner.
- Using a new male or female condom or dental dam every time you have vaginal, anal or oral sex.
- Using a new dental dam or latex gloves for rimming and fingering (exploring your partner’s anus with your fingers, mouth or tongue) or using latex gloves for fisting.
- Covering sex toys with a new condom and washing them after use.
- Getting vaccinated if you think you may be at an increased risk.
Apart from condoms, pre-exposure prophylaxis (PrEP) for HIV and contraception doesn’t protect you from hepatitis B and other STIs. Ask a healthcare professional if you need advice.
Hepatitis B can be passed on through sharing contaminated needles and syringes during recreational drug use. You can also get it from unsterilised tattoo, body-piercing or medical/dental equipment. Very occasionally, you can get it from sharing a towel, razor blades or a toothbrush if there is infected blood on them.
You can protect yourself by:
- Never share needles and syringes or other items that may be contaminated with blood, such as razors, toothbrushes and manicure tools (even old or dried blood can contain the virus).
- Only have tattoos, body piercings or acupuncture in a professional setting, and make sure new, sterile needles are used.
- Getting vaccinated if you think you may be at an increased risk.
Mother to child
Pregnant woman with hepatitis B can pass the virus on to their unborn baby, which is why women are routinely tested for hepatitis B as part of prenatal care. In almost all cases, an infection can be prevented if the infant receives the recommended vaccinations in time.
Infants infected at birth are more likely to develop chronic hepatitis B and go on to develop liver complications, so it’s important to talk to your doctor if you have any questions and follow any advice they give.
What are the symptoms of hepatitis B?
Many people with hepatitis B don’t have any symptoms. If you do get symptoms you may not notice them until two or three months after infection and they can last up to three months. There are two types of infection – acute and chronic.
Acute (or short-term) symptoms include:
- flu-like symptoms, including tiredness, fever and aches and pains
- feeling and/or being sick
- loss of weight/appetite
- tummy (abdominal) pain
- jaundice, meaning your skin and the whites of your eyes turn yellow
- dark urine (pee)
- pale faeces (poo).
People who can’t fight off acute infection after six months, such as babies, young children and people with a weakened immune system because of HIV, can go on to develop chronic hepatitis B. This is when people are at higher risk of liver failure, liver disease and cancer of the liver.
How do you test for hepatitis B?
A simple blood test carried out by a healthcare professional will show whether you have the virus. You may also be given extra tests to see if your liver is damaged.
If you’ve got hepatitis B you should be tested for other STIs. It’s important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis B don’t notice anything wrong, and by telling them you can help to stop the virus being passed on. This can also stop you from getting the infection again.
How is hepatitis B treated?
Acute hepatitis B infection
There is no specific treatment for acute hepatitis B, and most people recover within one to two months. Usually, you can manage symptoms at home with painkillers if necessary. Your healthcare professional should advise you to have regular blood tests and physical check-ups. Most people make a full recovery from acute hepatitis B.
Chronic hepatitis B infection
If you develop chronic hepatitis B, you’ll be given treatment to reduce the risk of permanent liver damage and liver cancer. Treatment does not cure chronic hepatitis B and most people who start treatment need to continue for life.
Without treatment, chronic hepatitis B can cause scarring of the liver (cirrhosis), which can cause the liver to stop working properly.
A small number of people with cirrhosis develop liver cancer, and these complications can lead to death. Other than a liver transplant, there is no cure for cirrhosis. However, treatments can help relieve some of the symptoms.
Hepatitis B and HIV
If you are living with HIV, or if you are at risk of HIV – for example, if you’re a man who has sex with men, sell sex or use drugs – you should ask a healthcare professional about getting the hepatitis B vaccine. That’s because people living with HIV are more likely to go on to develop chronic hepatitis should they become infected. They are also more likely to develop liver complications if chronic hepatitis is left unmanaged.
Having hepatitis B won’t make your HIV any worse. However, it's still important to let your doctor know if you test positive for hepatitis B so that they can more closely monitor your liver. Taking your antiretroviral treatment as prescribed is the best way to stay healthy with HIV and hepatitis B co-infection.
Photo credit: ©iStock.com/sarathsasidharan