Hepatitis B

Some people can develop hepatitis B disease and not be aware they are infected. Most children and up to half of the adults with hepatitis B have no symptoms at the time they are first infected. They do not get sick and they do not develop the yellow colour (jaundice) associated with liver disease.

Others do get sick and some are very unwell and may need to be admitted to hospital. Early signs of infection include pain in the abdomen, nausea, vomiting, weakness and tiredness, loss of appetite, general aches and pains and fever. This may be followed by jaundice (yellowing of the skin and whites of the eyes), dark urine and pale-coloured faeces (stools).

Unfortunately, there is no cure for hepatitis B. People with acute hepatitis B are advised to rest, drink plenty of fluids, avoid fatty/oily foods and alcohol and to have regular check-up tests with their doctor to ensure the infection clears and the liver recovers.

If hepatitis B is chronic, treatment choices should be discussed with a specialist liver doctor. People with chronic hepatitis B need to be monitored regularly as there is a risk of developing liver cirrhosis, and hepatocellular carcinoma.; People with chronic Hepatitis B are advised to limit or avoid alcohol, maintain a healthy well balanced diet, get adequate rest and have regular liver check-ups with a GP and/or specialist.

More than half of those infected with hepatitis B show few or no symptoms. This can be a risk as they may transmit the virus to others without knowing it.

The hepatitis B virus lives in blood or other body fluids. It is spread through blood-to-blood contact with an infected person which may include:

• sharing needles or syringes
• coming into contact with inadequately sterilised instruments (such as those used for tattooing and body piercing)
• sexual contact (hepatitis B is one of the most common sexually transmitted infections in the world).

Babies with infected mothers are also at very high risk of being infected with hepatitis B at birth.

Blood tests can be taken to check for hepatitis B. Blood tests show if a person has had hepatitis B in the past and whether the infection is acute or chronic. Tests can also show if there is any damage to the liver.

Control

If you find out that you have hepatitis B, you should notify your recent sexual partners and close contacts to advise them to have a sexual health check and provide them with an opportunity to be tested. This is to see if they are infected and to prevent further spread of the infection. If you feel uncomfortable or embarrassed about telling your partner or partners, the doctor, nurse or health worker can contact them. This is a confidential process and your name will not be mentioned.

There is a reliable and safe vaccine available to prevent the spread of hepatitis B (see immunisation).

As hepatitis B is spread through blood-to-blood contact with an infected person, it is important to practice safe sex and take care not to exchange body fluids during sex. People with more than one sexual partner (or whose partner has more than one sexual partner) are at risk of getting an STI like hepatitis B. Always using condoms and a water-based lubricant when you have vaginal or anal sex is the best way to reduce your risk of hepatitis B. If you are giving a man oral sex (his penis in your mouth), then he will need to wear a condom. If you put your mouth in contact with your partner's anus or vulva while having sex, you should use a dental dam as protection.

Injecting drug users should also take the following precautions:

• always use sterile needles, syringes and equipment
• never share injecting equipment
• dispose of equipment in solid, puncture proof and sealed containers to reduce risk of needle stick injury to others
• never recap needles.

Immunisation

There is a reliable and safe vaccine available to prevent the spread of hepatitis B. The National Immunisation Program Schedule funds hepatitis B vaccine for:

• babies (given at birth, six weeks, four months and six months of age)
• Year 8 students in Queensland who have not already received a course of hepatitis B vaccinations (two doses, given four to six months apart, will be offered free of charge through the School Based Vaccination Program until the end of 2013 as universal infant vaccination commenced 1 May 2000)
• the following at risk groups for hepatitis B:
  • household or other close (household-like)contacts of people with acute or chronic hepatitis B
  • sexual contacts of people with acute hepatitis B
  • migrants from hepatitis B endemic countries - includes most East and Southeast Asia (except Japan) Pacific island groups, parts of central Asia and the Middle East, the Amazon Basin and sub Saharan Africa
  • Aboriginal and Torres Strait Islander people
  • Persons who inject drugs
  • people with hepatitis C or chronic liver disease
  • HIV positive adults and other immunocompromised adults
  • sex industry workers.

The vaccine is also recommended (but not funded) for other people at high risk of exposure to the disease:

• adult haemodialysis patients and patients with severely impaired renal function in whom dialysis is anticipated
• solid organ and haematopoietic stem cell transplant recipients
• recipients of certain blood products
• persons with developmental disabilities
• in-mates and staff of long-term correctional facilities
• persons at occupational risk directly involved in patient care and/or the handling of human blood or tissue such as health care workers, police, members of the armed forces, emergency services staff, staff of correctional facilities assigned to duties that may involve exposure to blood/body fluids
• travellers to hepatitis B endemic areas
• police, emergency services staff, members of the armed forces assigned to duties which may involve exposure
• others at risk including funeral workers, embalmers, staff in residential and non-residential care of persons with developmental disabilities, tattooists, body piercers.

The main predictor of disease course is age of infection:

As people with hepatitis B are carriers for the disease, they:

• must not donate blood, semen or organs
• should inform their doctor, dentist and other relevant health workers of their hepatitis B status

For further assistance, please contact your local doctor, sexual health clinic, family planning clinic or public health unit. You can be immunised at your local doctor or medical centre. Check with your local council, community child health and community health centre regarding free immunisation clinics

Related Content

• Having a vaccination what to expect

Other Resources

• 13 HEALTH (call 13 43 25 84)
• Queensland Health immunisation
• Sexual health - information
• Immunise Australia (call 1800 671 811)

References

Heymann D, (ed). 2008. Control of Communicable Diseases Manual (19th ed). Washington, DC: American Public Health Association.