Hepatitis B
Hepatitis means "inflammation of the liver". Hepatitis
B is a sexually transmitted virus that can cause scarring of the liver,
liver failure, and liver diseases like cirrhosis and liver cancer.
Throughout the world, Hepatitis B is very common.
Hepatitis B is incurable, but a vaccine does exist and most infections will clear up on their own. Most people will have no symptoms of an infection. For these reasons, many people who are infected with hepatitis B may never know it and still transmit it to others.
Hepatitis B can be either a short-term "acute" infection
or a long-term "chronic" infection.
When a person first becomes infected with the hepatitis B virus, they
are said to have an acute infection.
During this time, a person may or may not have symptoms. For those that do, they may have few or very mild flu-like symptoms, or in rare cases they may have very severe symptoms requiring medical attention (i.e. jaundice, abdominal pain, cutaneous eruption, joint pain).
An acute infection can last up to six months, during which a person
can spread the virus to others. About 90% of adults will recover from
the acute stage within a few months of infection, as their bodies
develop immunity to the virus and fight off the infection. These people
won't develop chronic hepatitis. Their symptoms (if they had any)
will disappear and they will no longer be able to spread the virus
to others, and they typically have no long-term effects of the infection.
For others, their bodies won't be able to fight off the virus, and
will develop chronic hepatitis, a long-term infection of the liver.
These persons are called "chronic carriers" and can spread
the infection all their lives.
A person has chronic hepatitis if the infection persists more than 6 months. About 350 million people worldwide have long-term hepatitis B infection. Chronic hepatitis B may last for life; however, an infected person may have no symptoms. Whether they experience symptoms or not, an infected person can actively pass the disease to others.
Those with a chronic hepatitis infection may develop serious liver damage over time. Chronic hepatitis B infections contribute to a higher risk of liver failure and liver diseases such as cirrhosis and liver cancer. In some cases, complications of liver damage cause death.
Transmission
Hepatitis B is a sexually transmitted infection that can be passed through anal, vaginal, or oral sex with an infected partner.
It can also be passed along through blood-to-blood contact like sharing needles for drug use, or by sharing personal items like razors or toothbrushes that have come into contact with infected blood.
Prevention
If you are at higher risk of contracting the virus, ask your healthcare professional about getting the hepatitis B vaccine.
Practice safer sex using condoms, or abstinence.
Never share personal items like razors or toothbrushes with an infected person.
Avoid activities tat could cause you to be exposed to infected blood or semen.
Never share needles for injection drugs.
Symptoms
In many acute and chronic infections, the person infected will have no symptoms. These cases may go completely unnoticed, or unnoticed for a long period of time after infection.
Symptoms of acute hepatitis are often mild and may be mistaken for the flu. They include: tiredness, aching joints, pain in the stomach area, loss of appetite, nausea and a general feeling of sickness. Sometimes, hepatitis B may also cause jaundice, which is a sign of liver problems.
At first, many people with chronic hepatitis infections will have no symptoms. However, a chronic infection can cause serious liver scarring, and sometimes-fatal liver diseases including cirrhosis and liver cancer. People who are infected with the virus but do not show symptoms can still pass the infection to others. Drinking alcohol can speed the destruction of the liver in people with hepatitis.
For those who do show symptoms of the infection, these symptoms will usually begin to appear within 45 to 180 days of infection.
Testing and Treatment
Hepatitis B can be detected with a blood test.
There are some treatments available for chronic hepatitis B infections that help control the virus from spreading. However, these medications are not recommended for everyone.
Impact if not treated
Hepatitis B can cause permanent liver damage, cirrhosis, liver cancer or failure.
People with weakened immune systems because of HIV infection are at a much higher risk of developing a chronic hepatitis infection.
About the vaccine
The hepatitis B vaccine works by tricking your body into thinking it actually has the virus. The vaccine is not actually a virus and will not hurt you, but to your body, the vaccine "looks" exactly like the hepatitis B virus. Because your body thinks a virus is invading it, it will build up defenses to try to fight it off. To do this, your body produces special cells, built for the specific purpose of fighting off hepatitis B. Your body will continue to produce these defenses long after the vaccine is gone. This way, if you ever get the real hepatitis B virus, your body will have defenses ready, and will be able to fight off the virus before it establishes itself in your body.
In Canada, all provinces and territories currently have a universal childhood hepatitis B immunization program in place.
The vaccine may be recommended for:
- people who are at high risk, such as people who have many sexual partners or men who have sex with men
- people who share needles
- people who work in environments where they may come into contact with contaminated blood or body fluids, and people who require transfusions or blood procedures
- a person whose partner has hepatitis B
- people who have certain liver diseases
What do I tell my partner?
If you have an existing partner and are diagnosed with an acute or chronic hepatitis infection, be honest and ask them to go for testing. Remember, the vast majority of adults who are infected with HBV won't develop a chronic infection. Your partner may have already cleared an HBV infection with mild or no symptoms. Or, they may never have been infected.
However, there is also a chance that they will develop a severe acute infection or a chronic infection. So be honest, tell your partner, explain the risks and consider offering to accompany them for testing.
If testing determines that your partner has never been infected with hepatitis B, he or she will not have immunity to the virus. In this case, you might want to ask your partner to consider getting the Hepatitis B vaccine.
For new partners: Chronic hepatitis B virus can be spread, is incurable and can be very serious. For this reason, if you have an infection and are starting a relationship with a new partner, you have a responsibility to inform them. Explain the risks and that a vaccine exists, and that he or she may want to be vaccinated. Talk to your healthcare provider about the vaccine, safer sex methods including condoms, and ways to reduce the risk of transmission.
When can I have sex again?
You can have sex after an acute case clears up and you are no longer infectious. Remember, you may still be infectious even if you have no symptoms. You will need to see a healthcare professional for testing to be sure the infection is gone. As always, you should practice safer sex to reduce the risk of transmission of hepatitis B or other STIs.
If you have a chronic hepatitis B infection, consult a healthcare professional before having sex again.