Hepatitis B

What is it?

Hepatitis B is an infection of the liver caused by the hepatitis B virus. It is very infectious (100 times more infectious than HIV) and very easily transmitted through unprotected sex or by sharing needles to inject drugs.

Most people who contract hepatitis B do not have symptoms. If symptoms do occur they can appear one to six months after coming into contact with the virus. The infection can persist for many years and silently cause severe liver damage, including cirrhosis, liver failure and liver cancer.

In most people a full course of vaccination prevents infection. However, in a small number of people it may not be effective.

The following people should consider having the hepatitis B vaccination:

• Men who have sex with men
• Anyone who has ever injected drugs
• Anyone who has been paid for sex
• Anyone who has paid for sex
• Anyone who has had nine or more sexual partners within the last 12 months
• Anyone who has a sexual partner with hepatitis B infection
• Anyone who has recently been sexually assaulted

How do I catch it?

Hepatitis B infection can be passed on:

• through unprotected anal, vaginal or oral sex (sex without a condom)
• as a result of blood-to-blood contact:
  • via sharing of injecting equipment, such as needles, spoons and filters
  • through the use of non-sterile needles for tattooing, piercing or acupuncture
• through transmission from mother to baby during pregnancy, when giving birth or during breastfeeding. All pregnant women in the UK are tested for hepatitis B
• if you work closely with blood and bodily fluids

There is a small risk of catching the hepatitis B virus from sharing toothbrushes, razors or towels which may be contaminated with infected blood.

Symptoms

Many people with hepatitis B do not even realise that they are infected and most people who are infected have no symptoms for many years.

Occasionally patients infected with hepatitis B may have some symptoms after the initial infection. These could be any of the following:

• A mild flu-like illness
• Feeling sick and vomiting
• Diarrhoea
• Loss of appetite
• Jaundice (yellow skin and whites of eyes, and dark urine)
• Itchy skin

Testing

Hepatitis B is diagnosed by a blood test.

If you’re aged 16 or over and living in Birmingham or Solihull, you can request a free sexually transmitted infection (STI) self-sampling kit. Just follow the instructions in the kit to take your own samples, and return to us for testing, all for free. (For men who have sex with other men, a test for hepatitis B is included.)

Prevention

Vaccination

In most people a full course of hepatitis B vaccination prevents infection. However, in a small number of people it may not be effective.

Vaccination is done through a course of injections into the upper arm. It is essential to complete the full course.

• You will have blood taken before the first vaccination is given to ensure that you do not already have hepatitis B
• After you have received the injection, we recommend waiting 10 minutes in the clinic in case of any reaction to the vaccine
• A booster vaccination is recommended five years after completing the course if you remain at risk of infection

Possible side effects of the vaccination include:

• localised pain in the arm
• flu-like symptoms for up to 72 hours

Who should be vaccinated?

The following people should consider having the hepatitis B vaccination:

• Men who have sex with men
• Anyone who has ever injected drugs
• Anyone who has been paid for sex
• Anyone who has paid for sex
• Anyone who has had nine or more sexual partners within the last 12 months
• Anyone who has a sexual partner with hepatitis B infection
• Anyone who has been sexually assaulted recently

Many Umbrella clinics offer the hepatitis B vaccination. (We do not provide hepatitis B testing or vaccinations for travel or occupational health reasons. You would need to consultant your GP or employer’s occupational health department.)

Condoms

Using condoms can protect against catching hepatitis B infection through having sex

Treatment

If you have chronic or acute hepatitis B we will refer you to your GP for further assessment.

There is treatment available for chronic/long-term hepatitis, which a liver specialist can prescribe.There is a good vaccination available to prevent people catching hepatitis B and we recommend and provide it for people at risk of catching it through having sex.