Hepatitis B (HBV)

Hepatitis is an inflammation of the liver. This can be caused by alcohol and some drugs, but usually it is the result of a viral infection. There are many types of the virus which can cause hepatitis. Each of these viruses acts differently. The Hepatitis B virus (HBV) is very common worldwide. It is very infectious.

The virus can be spread in the following ways:

• By unprotected penetrative sex with someone who is infected. Also by sex which draws blood with someone who is infected.
• By sharing contaminated needles or other drug injecting equipment.
• By using non-sterilised equipment for tattooing, acupuncture or body piercing.
• From an infected mother to baby, mainly during birth.
• Through a blood transfusion in a country where blood is not tested for HBV.

Signs and symptoms – what to look out for

People may have no symptoms at all, but they can still pass on the virus to others. Symptoms may include:

• A short, mild flu-like illness.
• Nausea and vomiting diarrhoea loss of appetite weight loss.
• Jaundice – yellow skin and whites of eyes, darker yellow urine and pale faeces (poo).
• Itchy skin.
• Some people may need to be admitted to hospital.

Most adults infected with HBV fully recover and develop life-long immunity. Between 2% and 10% of individuals infected as adults will become chronic carriers, which mean they will be infectious to others and can develop chronic liver damage. Infected children and babies are more likely to become carriers.

If a person continues to be infected over a number of years with HBV, they could develop the following complications:

• Chronic hepatitis.
• Liver cirrhosis.
• Liver cancer.

The tests for HBV

Your GP or medical specialist at the GUM/sexual health clinic can diagnose HBV by carrying out blood tests. You will be asked questions to try to discover the source of infection.

What does a POSITIVE result mean?

• Past infection: This means that you have been in contact with HBV and your body has rejected it. You now have a natural protection against the virus.
• Carrier: This means that you carry HBV and can pass it on. You are at risk of chronic liver disease.

What does a NEGATIVE result mean?

This result means you have never come into contact with HBV and have no natural immunity. If there is a chance you have recently become exposed to HBV, your medical specialist may advise you to be immunised against HBV.

Diagnosis and treatment

Many people do not require treatment, as the inflammation of the liver may not be severe.

Immunisation

A vaccination is available to protect you from Hep B, if you think you may be at risk, contact your local sexual health clinic.

Three injections are given over a period of time. A blood test is taken once the course of injections is completed to check they have worked. They should protect you for 5 years.

Follow-up

• If you are diagnosed as having an active infection you will be advised to have regular blood tests and check-ups.
• If you are infected with HBV, you should limit the amount of alcohol you drink. You may also be given some dietary advice.
• If you have Hepatitis B, you should use a condom for penetrative sex to prevent passing on the virus.
• If you have partner they should also be immunised.

Remember, using condoms can reduce your risk of getting or passing on sexually transmitted infections.

What next?

• Your own GP.
• Your local NHS GUM/Sexual Health Clinic – you will get free confidential advice and treatment here.
• A hospital A&E Department.