Hepatitis B

How is it spread?

The hepatitis B virus is spread through contact with blood or other body fluids (such as saliva, semen, vaginal secretions, and rectal fluid) of an infected person.  This can happen through sexual intercourse (anal, oral or vaginal), sharing unclean needles, injection equipment or other drug paraphernalia or sharing unsterilized tattoo or body-piercing equipment.  An infected mother can pass the virus to her baby during childbirth.

Hepatitis B can be spread to household contacts by sharing razors, food utensils, and toothbrushes that have come into contact with infected blood.  Screening of all donated blood has reduced the chance of getting hepatitis B from a blood transfusion.

What are the symptoms?

Up to 50% of adults who get the hepatitis B virus will have no symptoms but can pass the virus on to others.  If symptoms appear, they tend to be mild and flu-like.  Symptoms may include fatigue, nausea, vomiting, fever, and/or loss of appetite. Some people develop dark urine, light-coloured stools, and jaundice (yellowish skin and/or eyes).  Symptoms tend to occur 6 weeks to 6 months after exposure and can last from a few weeks to 6 months.

How is it diagnosed?

Hepatitis B is diagnosed through a blood test. If you test positive for hepatitis B, your health care provider will also order other types of blood tests to evaluate liver function. Blood tests are repeated to assess recovery.

How is it treated?

There are no medications for treating acute hepatitis B. Doctors usually recommend getting plenty of rest, lots of fluids, and adequate nutrition. For chronic hepatitis B, however, there are many types of antiviral drugs available to treat it, although there is no cure for it. People should seek advice from a physician/specialist with experience treating chronic hepatitis B.

What are the complications?

Chronic hepatitis B infection significantly increases the risk for liver damage, including cirrhosis and liver cancer. About 1% of chronic hepatitis B carriers will go on to develop liver cancer.

Prevention

Hepatitis B vaccine

here is a vaccine available to prevent hepatitis B. It is given in three doses over a period of six months. All people at high risk for infection should consider receiving the vaccine. This includes anyone who is sexually active, people with HIV, injection and non-injection drug users, and people with chronic liver disease (i.e. hepatitis C). Household and sexual partners of chronic carriers and acute cases should also be vaccinated. It is a publicly funded vaccine for those in the at-risk groups.

Some precautions for preventing the transmission of hepatitis B include using condoms when having sex, not sharing personal items such as razors or toothbrushes, and not sharing drug needles or other drug paraphernalia (such as pipes or straws).

Hepatitis B vaccine side effects

Most common

Soreness and redness (mild and short-term) at the injection site

Uncommon

Fever, fatigue, headaches, and flu-like symptoms

 Rare

The risk of developing a severe allergic reaction (hives, difficulty breathing, and/or swelling of the face or mouth) is extremely rare (less than 1 in 500,000).  It usually occurs within the first 15 minutes after the injection so you should remain in the clinic for 15 minutes after each dose of the vaccine.  If you have an allergic reaction to the first dose, you should not get any further hepatitis B vaccinations.

Note: there is no evidence that hepatitis B vaccination causes any chronic conditions such as chronic fatigue syndrome, rheumatoid arthritis, multiple sclerosis or Guillain-Barre syndrome.