Hepatitis B

Last updated: 06 December 2007

What is Hepatitis B?

• Hepatitis B is an infection of the liver caused by a virus called hepatitis B. 'Hepatitis' means 'inflammation or swelling of the liver'.
• Once infected, people will either clear the infection and have no further problems; or
• become chronically infected. People with chronic infection are sometimes known as 'carriers'.
• Some people with chronic infection can have health problems related to the infection, while others will not. Whether a person clears the infection or becomes chronically infected depends mainly on their age: 90% of newborn babies, 20-50% of children aged 1-5 years, and 1-10% of older children and adults, become chronically infected. People with chronic infection are usually infectious for life, and may develop ongoing hepatitis. After many years this can result in complications such as cirrhosis or liver cancer.

What are the symptoms?

• Many people will have no symptoms when they are newly infected.
• When symptoms are present they usually include jaundice (yellowing of the skin and eyes), dark urine, pale stools, fatigue, abdominal pain, loss of appetite, nausea, vomiting and joint pain.

How is it spread?

Hepatitis B is passed on to others when blood or bodily fluids (for example, saliva, semen and vaginal secretions) that contain the hepatitis B virus enter a person's body through:

• Broken skin
• Mucous membranes
• The bloodstream by sharing contaminated injecting equipment, or using needles after an infected person, needlestick injury, or contaminated instruments.
• Having sex with an infected person without using a condom.
  Hepatitis B can also be passed on to a baby at birth from an infected mother.

Who is at risk?

People at risk of infection include:

• Sex partners of infected people
• Injecting drug users
• Babies born to infected women
• People with multiple sex partners
• Men who have sex with men
• Haemodialysis patients
• Health care workers
• Children of people born in countries with high rates of hepatitis B infection
• Household contact with people infected with hepatitis B
• Prisoners.

How is it prevented?

Immunisation
Hepatitis B vaccine is very effective in preventing infection. It is recommended for:

• All children at birth, two, four and six months of age. Vaccines are given in the birth hospital and by your local doctor or clinic as part of the routine childhood vaccinations.
• All 12 year old children who were not immunised as babies. Vaccines are offered at high at school.
• Those who have household or sexual contact with chronically infected people
• Men who have sex with men
• People with sexually transmissible infections
• Injecting drug users
• Haemodialysis patients
• People who receive blood products for clotting disorders
• People with chronic liver disease or hepatitis C infection
• Residents and staff of facilities for persons with intellectual disabilities
• Inmates and staff of correctional facilities
• Health care workers
• Embalmers
• Emergency workers.

• Get vaccinated
• Use condoms if you are having sex with new sexual partners or with partners infected with hepatitis B if you have not been vaccinated
• If you are pregnant, you should have a blood test for hepatitis B; infants born to hepatitis B infected mothers should be given hepatitis B immunoglobulin (HBIG) and vaccine within 12 hours after birth
• Do not share injecting equipment
• Do not share personal items that may have blood on them (for example, razors or toothbrushes)
• If having a tattoo or your body pierced, make sure that the practitioner uses disposable and sterile equipment
• Non immune contacts of a person infected with HBV should be given HBIG and vaccine as soon as possible, for exposure to blood within 72 hours; for sexual exposure within 14 days.

• Do not donate blood, organs or tissue if you have hepatitis B
• Advise your doctor and dentist that you are infected
• Be very careful to make sure that other people are not exposed to your blood or body fluids. Clean up any spills with a paper towel and clean thoroughly with detergent and water until no obvious stains are left. If a large blood spill occurs on carpet, it may need to be shampooed or steam cleaned.
• Cover your wounds with a waterproof bandage
• Use condoms with new sexual partners, and with partners who are not already immune.

How is it diagnosed?

A blood test can show if a person has been infected with hepatitis B in the past, and whether a person is chronically infected. Other tests, such as liver function test, can show if any damage has been done to the liver.

How is it treated?

Some people may benefit from special anti-viral treatment. Talk to your doctor about possible treatments. People with chronic hepatitis B infection should take care of their livers and have hepatitis A vaccination if not already immune. Drinking alcohol can make you liver disease worse.

What is the public health response?

Hepatitis B is notifiable by both doctors and laboratories. Public health unit staff investigate cases of new infection to identify risk factors and help control further spread.