Hepatitis B

---

People with hepatitis B come from all social, educational, cultural, religious and economic backgrounds. It can affect people no matter what age, gender or sexuality.

The emotional and physical effects of hepatitis B can vary between people. This section of the website is intended to assist people who would like some more information on the virus; from its effects on the body, how to avoid transmission, identification of risk behaviours, what to expect if living with hepatitis B, testing procedures and treatment options.

Lifestyle choices are important in managing the effect of hepatitis B.  Beneficial choices include good nutrition, moderate exercise, meditation and complementary therapies such as massage and yoga. More information on this is available here. Many of the strategies outlined for hepatitis C are also useful for people affected by hepatitis B.

Hepatitis B

Hepatitis B is also known as serum hepatitis. It can develop into chronic (long-tern) infection for five to ten percent of people infected as adults, and up to ninety percent of people infected at birth (Berkman & Bakalar, 2000). There is an average incubation period of up to six months, after which symptoms may or may not occur. During this period a person is at risk of transmitting the virus. If hepatitis B is cleared from the body, antibodies produced in response will provide immunity for life (WA Department of Health 2005b). All Australian jurisdictions are required to report diagnosis of hepatitis B to the National Notifiable Diseases Surveillance System (Department of Health and Ageing, 2005).

It is estimated that approximately 107 000 people living in Australia have been diagnosed with hepatitis B (Australian Government Department of Health and Aging, 2006). Many more may have been exposed to the virus but have cleared it or did not develop symptoms.

Transmission and prevention: Hepatitis B is a sexually transmitted infection as it is present in semen, vaginal fluids and blood. The virus has also been detected in saliva, urine and other body fluids such as breast milk in very small quantities.

Transmission can occur via direct blood-to-blood contact, unprotected sex and sharing injecting, tattooing or piercing equipment. A pregnant woman carrying the virus may also pass it on to her baby during delivery, so it is important that medical staff are aware of her hepatitis B status and viral load.

Other possible routes of infection include sharing sharp household items such as razors, toothbrushes or earrings. It is important to note however, that hepatitis B is NOT transmitted casually, such as through sneezing, coughing, hugging or eating food prepared by someone who is infected with hepatitis B.

Symptoms: Many of the symptoms of hepatitis B can be attributable to a number of conditions, making diagnosis without clinical testing difficult. Symptoms may be similar to those for influenza, and may include loss of appetite, nausea and vomiting, fever, chills and weakness. Abdominal pain, dark urine and jaundice associated with the liver may also be present (Berkman & Bakalar, 2000). Symptoms generally occur after the window period of approximately three to six months. In acute (short term) infection symptoms come on gradually and last up to five or six weeks. After this time, fatigue and malaise may linger for a few weeks (Berkman & Bakalar, 2000).

About half of adults infected with hepatitis B and almost all children will not experience symptoms at all (WA Department of Health, 2005b). If a person believes they may have been exposed to the virus, it is important to see a doctor for testing.

Testing and treatments: Testing for hepatitis B involves a blood test, which can be arranged at most doctor surgeries and health clinics. Test results should be discussed with a health care provider. For more information on testing, please click here for the Living with Hepatitis section on this website.

In Australia treatment for chronic (long term) hepatitis B is available free of charge at major hospitals through liver clinics. Please contact the Hepatitis Council of WA for further details. In order to qualify for treatment, a person must have had hepatitis B for at least six months (classed as chronic hepatitis B), and blood tests must show that the virus is active and liver damage is occurring. Some people may need a liver biopsy which is a clinical procedure where a very small piece of liver is removed with a needle to determine how much liver scarring and inflammation has occurred (Doyle & Urban, 2005).

Hepatitis B treatment uses Pegylated Interferon (as with hepatitis C) and comprises of a weekly injection for six months. Interferon is a naturally occurring part of the body’s immune system. Additional doses assist by boosting the body’s immune response, as well as interfering with the virus’s ability to reproduce (Doyle & Urban, 2005).

For more information on treatments, please click here.

Vaccination: Vaccination against hepatitis B has been part of routine childhood programs since 2000. Adult immunisation requires an initial injection, followed by another after one month, then at six months from the initial dose (Australian Society for HIV Medicine Inc, 2004). A combined vaccination for hepatitis A and hepatitis B is available. It is recommended for people who are living with hepatitis C and/or HIV, people who work in the health or care sector, travelers, men who have sex with men, people who inject drugs, people in prison or people who work in a prison. Vaccinations are available from a GP and some specialized clinics. Please contact the Hepatitis Council for further information.

Checklist: a person could have hepatitis B if they have:

1. shared injecting drug equipment (needle/syringe, tourniquet, water or spoon)
2. had a tattoo or piercing using un-sterile equipment
3. worked in an environment which brings them into contact with other people’s body fluids such as blood (eg disability care, nursing, first aid)
4. had a blood transfusion in Australia before 1991
5. had unprotected sex with someone who has hepatitis B
6. experienced dialysis
7. had a medical/surgical procedure or immunization overseas
8. shared a razor, toothbrush or other sharp grooming instrument that belongs to someone who has hepatitis B
9. taken part in a ritual involving human blood
10. handled blood-stained clothing or attended to a wound without adequate protection (eg latex gloves, resuscitation masks etc)

Bibliography