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Hepatitis B symptoms and treatment

Hepatitis B is part of a group of hepatitis viruses that attack the liver. It is spread through blood and bodily fluids. It is most commonly passed on via unprotected sex (sex without a condom or dental dam), from a mother to her child during birth, or through contaminated needles. 

In adults, it often causes no obvious symptoms and can pass in a few months without treatment. Children are more likely to develop a long-lasting (chronic) infection. Without appropriate treatment and care, children and adults with a chronic infection can become seriously ill and be at risk of liver damage or death. 

Vaccines for hepatitis B are offered to infants and are available for people at high risk of the condition. 

What is hepatitis B?

Hepatitis B, sometimes called Hep B or HBV, is part of a group of hepatitis viruses that attack the liver. For some people the infection becomes chronic, meaning it lasts more than six months. People with chronic hepatitis B have a higher chance of liver damage. 

Most adults with hepatitis B make a full recovery, even if their symptoms are severe. Babies and children are more likely to develop a long-lasting (chronic) hepatitis B infection. 

How do you get hepatitis B?

Hepatitis B spreads when the blood, semen or vaginal fluids of an infected person gets into someone else’s body. The virus is highly infectious and can last outside the body for up to seven days. 

Hepatitis B is passed on by: 

  • having unprotected vaginal, anal and oral sex with someone who has hepatitis B* 

  • changing partners frequently and not using a condoms every time you have sex 

  • injecting drugs using contaminated equipment 

  • using unsterilised tattoo, body-piercing or medical/dental equipment.  

  • sharing towels, razor blades or toothbrushes with infected blood on them (this is rare).

Hepatitis B can also be passed on from a mother to her newborn baby, particularly in countries where the infection is common.  

* Some sexual activities are riskier than others, such as anal sex or any type of sex where blood may be present.  

For more details on hepatitis B in pregnancy read our ‘in detail’ tab. 

How do you prevent Hepatitis B?

You can stop the spread of the virus by using a new external (male) or internal (female) condom or dental dam every time you have vaginal, anal or oral sex. You should cover sex toys with a new condom and wash with soap and water after use. It’s also a good idea to use latex gloves and wash your hands after touching someone’s anus (bottom) or handling used condoms and sex toys. 

Taking pre-exposure prophylaxis (PrEP), the contraceptive pill or any other type of contraception – apart from condoms – won’t protect you from hepatitis B and other STIs. 

Having regular STI tests is one of the best ways to look after your sexual health. If you are having sex with multiple partners, it’s even more important to use condoms and get tested regularly, even if you don’t have any symptoms.  

You should never share needles and syringes or other items that may be contaminated with blood, such as razors. Only have tattoos, body piercings or acupuncture in a professional setting, and make sure new, sterile needles are used. 

Getting vaccinated is a good idea if you think you may be at risk. 

What are the symptoms of hepatitis B?

Many people with hepatitis B don’t have any symptoms. If you do get symptoms you may not notice them until two or three months after infection. You can pass the virus on to others even if you don’t have symptoms.  

There are two types of infection – acute and chronic. 

Acute (or short-term) symptoms can include: 

  • flu-like symptoms, including tiredness, fever and aches and pains 

  • feeling and/or being sick 

  • loss of weight/appetite 

  • diarrhoea 

  • tummy (abdominal) pain 

  • yellowing of the skin and eyes (jaundice) 

  •  dark urine (pee) 

  • pale, grey coloured faeces (poo). 

People who can’t fight off acute infection after six months can go on to develop chronic hepatitis B. These include babies, young children and people with a weakened immune system because of HIV. People with chronic hepatitis B are at higher risk of liver failure, liver disease and cancer of the liver.  

How do I test for hepatitis B?

A simple blood test carried out by a healthcare professional will show whether you have the virus. You may also be given extra tests to see if your liver is damaged. You can have a test even if you do not have symptoms

If you’ve got hepatitis B you should be tested for other STIs. It’s important that you tell your recent sexual partner/s so they can also get tested and treated.  

How is hepatitis B treated?

Treatment for hepatitis B depends on how long you have had the virus. 

There is no specific treatment for acute (short-term) hepatitis B, and most people recover within one to two months. Usually, you can manage symptoms at home with plenty of rest and painkillers if necessary. Most people make a full recovery from acute hepatitis B. 

If you develop chronic (long-term) hepatitis B, you will be given treatment to help some of the symptoms. This will also reduce the risk of liver damage and liver cancer. Treatment keeps the virus under control but cannot cure chronic hepatitis B. Some people will need lifelong treatment. 

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What are the long-term effects of untreated Hepatitis B?

Without treatment, chronic (long-term) hepatitis B can cause the liver to stop working properly. This scarring of the liver is called cirrhosis.  

A small number of people with cirrhosis develop liver cancer, and these complications can lead to death. Other than a liver transplant, there is no cure for cirrhosis. But, treatments can help relieve some of the symptoms. 

What if I’m pregnant and have hepatitis B?

Pregnant woman with hepatitis B can pass the virus on to their unborn baby. This is why women are tested for hepatitis B as part of prenatal care. In almost all cases, an infection can be prevented if the infant receives the recommended vaccinations in time.  

Infants infected at birth are more likely to develop chronic hepatitis B and go on to develop liver complications. It’s important to talk to your doctor if you have any questions and follow any advice they give. 

How do I tell my recent sexual partner(s) I have hepatitis B?

If you test positive for hepatitis B, it’s important to tell any recent sexual partner(s) so they can also get tested, and treated if necessary. If you feel it is safe to do so then telling a partner is the responsible thing to do – it shows you respect them and want them to stay healthy. 

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