Hepatitis B, sometimes called hep B or HBV, is a virus carried in the blood and body fluids which infects and damages the liver.  Hepatitis simply means “inflammation of the liver”.   The liver is a big organ in the upper right side of the belly.

In the UK, approximately one in 350 people are thought to be chronically infected with hepatitis B. In some inner-city areas, with a high percentage of people from parts of the world where the virus is common, as many as one in 60 pregnant women may be infected.

Hepatitis B is very infectious, 50 – 100 times more infectious than HIV.

The only way to know if you are infected is to take a simple blood test.

Several medications are available for the treatment of hepatitis B.

Hepatitis B infection can be prevented by vaccination of people at risk.

Hepatitis B is known as a ‘blood-borne virus’ and can be spread by blood to blood contact. It is also present in other body fluids which can be a source of infection, particularly if they have become contaminated with blood.

1)

Sex

 without a condom

— Sexual contact without a condom with someone who is infected is one of the most common ways to become infected with hepatitis B.  Sexual partners of someone infected with hepatitis B should be vaccinated.

2)

Contaminated needles

— Injecting drugs, including steroids or sharing any needles, syringes, or other drugs ‘works’ is high risk for hepatitis b transmission.  Hep B can also be passed through needles used for tattooing, acupuncture or ear piercing if these procedures are performed with contaminated instruments. The best way to protect yourself is to ensure that disposable needles are used and that they come straight out of a sterile packet.

3)

Mother to infant

— Hepatitis B can be passed from a mother to her baby during or shortly after delivery.  Since April 2000, all pregnant women in the UK have been offered screening for hepatitis B.  If a mother is known to be hep B positive measures can be taken to prevent transmission to her baby in the majority of cases.  There have been no reports of transmission through breast feeding.

4)

Travel

– More than 12% of cases in the UK are thought to result from people travelling to, working in countries where there is an increased risk of hep B infection.  Around 40% of these cases are due to having sex without a condom.  Travellers to countries where hep b is common should be vaccinated.  Being born in a country where hep B is common does not mean you are naturally protected.

5)

Close contact

— Hepatitis B is able to survive outside the body for at least a week which means it can be spread by sharing household items like toothbrushes or razors.

Nowadays, it is extremely rare for hepatitis B to be spread through blood transfusion or organ transplantation. Blood and organ donors are carefully screened for markers of hepatitis infection.

Hepatitis B is not passed on through social contact, for example, holding hands, hugging, sharing towels, cups, plates or cooking utensils

Many people with hepatitis B never have any symptoms and, as people may not know they are infected, they can pass on the virus to others without realising.  The absence of symptoms does not mean the virus is under control.

Soon after a person is first infected they may develop a flu like illness.  A few people develop a serious illness and need to be looked after in hospital. More severe symptoms may include:

• diarrhoea
• pale bowel motions
• dark urine
• jaundice (a condition in which the whites of the eyes go yellow and in more severe cases the skin also turns yellow)

Hepatitis B can cause an acute or a chronic illness.

An acute illness is a sudden illness that lasts for a short period (less than six months). It can take a while to recover from acute hepatitis B.  Some people may recover and ‘clear’ (rid) the virus from their body without ever knowing they have been infected.  Their blood will always show the hepatitis B antibodies but they should never be infected again (they become ‘immune’).

A chronic illness is one that lasts more than six months, possibly for the rest of your life. Sometimes symptoms may come and go. Up to one in ten people (between 5 and 10%) with acute hepatitis B may go on to have chronic hepatitis B if infected as an adult. Up to 95% of children infected will remain infected. Many people are infected in childhood and are often not aware that they have hepatitis B. Another important reason to get tested.

If you have a positive test for hepatitis B you will be asked to see a specialist doctor.  You will need some further tests to assess for liver damage.  It is also important to test for other infections which can be transmitted the same way as hepatitis B, like hepatitis C and HIV.  Your doctor will assess whether you need treatment and discuss this with you.

Most people do not require treatment for acute hepatitis B.

Chronic hepatitis B often requires treatment to stop or reduce the activity of the virus from damaging the liver, by limiting the replication (reproduction) of the virus. Not everyone will require treatment straight away. If you have low levels of the virus in your blood (a low viral load) and there is little sign of liver damage, it is likely that regular monitoring will be recommended and treatment started only if there are signs of disease progression.

If you are diagnosed with hepatitis B you will need to inform close family members, such as your partner or children, so that they can consult a doctor to be tested and vaccinated against the virus.

If you are having any other medical treatment, visiting the dentist, having a tattoo, body piercing or acupuncture; you should let the practitioner know that you have hepatitis B so they can take precautions to protect themselves and others.

Using a condom will help protect your sexual partners from hepatitis b.

You have no legal obligation to inform your employer. However, you do have a legal duty to ensure your own health and safety and that of others while at work. The type of work that you do will influence the level of risk to others. Working with your employer means you can prevent others being infected. If you do decide to tell your employer they are obliged to keep this information confidential and cannot pass it on without your consent.

Taking a test will allow you to look after yourself and others.