Hepatitis B

Is a virus that can infect and damage the liver.

How is it passed on?

Hepatitis B is carried in the blood. It is usually transmitted through blood to blood contact. Examples include:

• sharing needles when injecting drugs;
• a cut in the skin that comes into contact with infected blood;
• use of unsterilised equipment when getting a tattoo/body piercing;
• sharing razors or toothbrushes that are contaminated with infected blood;
• unprotected sex.

Although transmission through sex is rare, it is 50-100 times more infectious than HIV. In the UK, it is more common in men who have sex with men and it can be prevented by using a condom and by vaccination.

Hepatitis B is more common in certain parts of the world, such as Africa, Asia, South America and Eastern Europe. In these countries, it may be acquired in childhood.

A mother can pass Hepatitis B infection to her newborn baby, but the infection can be prevented if the baby is vaccinated immediately after birth.

Symptoms

During the early stage of infection there may not be any symptoms. If symptoms do develop, this is usually within the first 6 months after infection. Those who do get symptoms may experience:

• flu-like symptoms, such as muscle aches and loss of appetite, high temperature;
• feeling tired all the time;
• depression;
• one in five will experience yellowing of the eyes and skin (jaundice);
• loss of appetite and weight loss;
• sickness and diarrhoea.

Most people clear the virus after this initial stage and are then immune to the infection. These people will not be infectious. You can only be certain you have Hepatitis if you have a test.

Long term effects

Some people’s body cannot clear the virus and so they will develop a long term infection called chronic Hepatitis. Hepatitis B can lead to problems with your liver, including scarring of the liver (cirrhosis), often years after catching the infection.

Treatment

You should seek immediate medical advice if you think you have been exposed to Hepatitis B. It is possible to prevent infection with treatment, but to be most effective it should be given in the first 48 hours after exposure.

Hepatitis B can be managed at home in the early stages, using over-the-counter painkillers such as paracetamol. You may be prescribed codeine if the pain is more severe.

If you have chronic Hepatitis B, you will be symptom-free for much of the time. However, you may need to take medication to prevent liver damage and have regular tests done. There are now very effective medications that can suppress the virus over many years.

Telling your partner

If you are diagnosed with Hepatitis B you should tell anyone who you may have had blood to blood contact with, or unprotected sex with, since you became infected. In some cases this may be hard to work out, so it is best to discuss the risks to others with your doctor. Any contacts may have the virus without knowing it, so it is important for them to get tested.

How to avoid Hepatitis B

• Never share any drug-injecting equipment with other people (not just needles, but also syringes, spoons and filters).
• Don’t get tattoos or piercings from unlicensed places.
• Don't share razors, toothbrushes or towels that might be contaminated with blood.
• Use a condom, especially with a new partner, for vaginal, anal and oral sex;
• Get vaccinated.

Vaccinations

Hepatitis B vaccine is available on the NHS, and is recommended for people who are at risk of infection. This includes people who inject drugs, sex workers, men who have sex with men, and people whose partners or close family have the virus.