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Hepatitis BThis factsheet is for people who have been diagnosed with hepatitis B and those who want to know more about the virus. Hepatitis means inflammation of the liver and can have several causes, the most common of which is an infection with a virus. There are several different viruses that cause hepatitis. Each differs in the way it is passed from person to person and the effect it can have on health. Hepatitis B is sometimes called hep B or HBV. For information about hepatitis A or C please see the separate BUPA factsheets, Hepatitis A and Hepatitis C. What causes hepatitis?Hepatitis can have several causes including:
Of these, infection with a virus is the most common cause. How do you get hepatitis B?Hepatitis B is highly contagious - which means it can be passed from person to person very easily. It's 50 to 100 times more contagious than HIV. The virus is present in body fluids such as blood, saliva, semen and vaginal fluid. There are a number of ways you can get hepatitis B. From mother to babyThis is the most common way for hepatitis B to be spread worldwide. If the virus spreads from mother to baby it usually happens during childbirth. It is not common for hepatitis to be spread in this way in the UK. BloodIf blood from an infected person gets into your bloodstream you can get hepatitis B. There are a number of ways this could happen including:
SexIf you have unprotected sex with an infected person you can get hepatitis B. Where in the world is hepatitis B common?High-risk areas for getting the disease include South-East Asia, Africa, the Middle East, the Far East and southern and eastern Europe. SymptomsHepatitis B has an incubation period of about one to six months. The incubation period is the time from exposure to the virus to the start of symptoms. As with the other hepatitis viruses, some people never have any symptoms. They are known as asymptomatic carriers; they are still infectious and can unknowingly pass on the disease to others. Symptoms of the disease, when there are any, can be similar to severe flu. They can include:
Jaundice sometimes develops and makes your skin go yellow. This is caused by a yellow-coloured substance in the blood called bilirubin. It's usually broken down by the liver, but if your liver is affected by hepatitis, it's unable to break it down. Raised bilirubin levels in your blood cause the whites of your eyes to go yellow and your urine to become dark. Jaundice can also cause your skin to itch. Some people only develop a mild form of the disease. Whether serious or mild, the person with hepatitis B is very infectious. ComplicationsA very small percentage of people who are infected develop liver failure (called fulminant hepatitis) and require hospitalisation. They may be so seriously ill that they need a liver transplant. Acute and chronic hepatitis BHepatitis B can be "acute" or "chronic".
A person who has the virus in their body for a long time without experiencing symptoms is called a carrier. Most carriers are infectious but some get rid of the virus after a few years. DiagnosisYour doctor will examine you and ask you about your symptoms. He or she will also ask you a number of questions including if you have recently been abroad and if so which country or region you have visited. He or she may also need to take your sexual history to establish possible contacts. Your doctor may ask you for a blood sample. The sample will be sent to a laboratory for examination to find out if you are infected with the hepatitis B virus. If tests results show that you have hepatitis B you will need further tests which may include:
TreatmentMost people with acute hepatitis B do not need any treatment. If you are diagnosed with hepatitis B, your GP will generally advise you to rest as you may feel more tired than usual. Taking a painkiller that you would normally take for a headache, such as aspirin or ibuprofen, may be useful. Always read the patient information leaflet. You should not take paracetamol as it is processed by the liver. As your liver will not be working properly, it is also strongly advisable to not drink any alcohol. If you have jaundice and your skin is itchy you can try preparations such as calamine lotion or crotamiton (Eurax). If you have been infected with chronic hepatitis B you may find treatment helpful. Antiviral medicationAntiviral treatments are usually prescribed by a specialist nurse or consultant that your GP will refer you to. The antiviral drugs include the following.
These drugs are not suitable for everyone, your consultant or specialist nurse will give you advice about whether they are the best treatment for you. How can I avoid passing on the virus?If you are infected with hepatitis B it is important not to spread it to others. You should:
PreventionYou can prevent getting hepatitis B by avoiding the risk factors above (see How can I avoid passing on the virus?) There is also a vaccine available for people who are at increased risk of infection with the hepatitis B virus. You may be at increased risk either through work or contact with infected individuals or your sexual behaviour. ImmunisationImmunisation can give protection but is not a substitute for common sense precautions. Immunisation takes six months to give full protection. You have an initial injection followed by another one month later and another five months after that. You can then have a booster vaccine five years later. The vaccine is around 95 percent effective. Immunisation is recommended for people including those:
Ask your GP if you wish to be vaccinated or go to your local sexual health GUM clinic or a travel clinic. If you are at risk of getting hepatitis B at work speak to your employer about getting vaccinated. Immunoglobulin (HBIG)Immunoglobulin is an injection of antibodies against the hepatitis B virus. If you have been exposed to the hepatitis B virus then you may be advised to take immunoglobulin as well as the vaccine. It is more effective the sooner it is given after exposure to the virus. Immunoglobulin can also be given to newborn babies at risk of getting hepatitis B from their mother during childbirth. For further advice on protection against hepatitis B, talk to your GP or practice nurse. Further information
Sources
Published by BUPA's health information team, healthinfo@bupa.com, December 2006.
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