What is Hepatitis B?
Hepatitis B is a viral infection of the liver. The infection can follow a variable course; this means that different patients have separate symptoms and treatment needs. The Hepatitis B virus (HBV) usually results in an acute illness that resolves itself quickly without causing long-term liver damage.
However, in about 20% of cases it can cause a chronic illness that lasts more than six months, sometimes for life, with recurring symptoms. In 15-40% of patients with chronic infection cirrhosis, liver cancer or liver failure will develop, and the infection may eventually prove fatal.
How is it transmitted?
Hepatitis B is usually transmitted through contact with infected blood or bodily fluids. It can also be transmitted sexually. As Hepatitis B is so infectious, only a tiny amount of blood is required to contract the virus. The virus may also be present in saliva, vaginal secretions, breast milk and other bodily fluids.
As well as unprotected sexual intercourse, infection commonly occurs through the sharing of contaminated needles (e.g. intravenous drugs use), accidental injury with a contaminated needle (tattooing, body piercing or acupuncture) and the sharing of contaminated razors.
How will I know if I have it?
Hepatitis B infections often carry no symptoms, hence why it is so important to get tested as regularly as possible. Symptoms, if they occur, can include tiredness, aches, nausea, vomiting, passing darker urine, and jaundice.
You can have a Hepatitis B test individually, or combined with others as part of a Hepatitis or other STI screen. A blood sample is needed, and that same sample can also be used for other tests you may want to order.
The majority of people with Hepatitis B do not require specific treatment other than rest, and usually go on to make a full recovery.
However, it is important that the infection is continually monitored, to check whether chronic disease develops. The person should also receive advice about the risk of transmitting the infection. If the infection lasts for more than six months (a chronic infection, where the virus continues to actively reproduce in the body), you may need more specific drug treatment to reduce the risk of permanent liver damage (cirrhosis) or liver cancer.
You should be referred to a specialist in either liver disease (a hepatologist) or general digestive diseases (a gastroenterologist). They may recommend antiviral medication which will help to boost your immune system to fight infection. The response to treatment is variable, and some people whose conditions initially improve may deteriorate once the treatment is halted. Others may find that side effects may mean that they cannot continue with the treatment.
If left undetected and untreated, the Hepatitis B virus can weaken your immune system, increasing your risk of contracting other infections, such as HIV. A lack of treatment can also cause chronic inflammation of the liver, potentially leading to liver cancer.
If you are pregnant, your midwife will be able to advise you and minimise the risk of transmission to your baby.