Hepatitis B (often known as HBV) is a type of viral hepatitis that causes inflammation of the liver. You can avoid hepatitis B by having a vaccination.
Having a healthy liver is important for everybody, but it's especially important for people living with HIV.
Your liver has an essential role in processing medicines used to treat HIV and other conditions. Viral infections that affect the liver, such as hepatitis A, hepatitis B and hepatitis C, can make you ill and also mean that your liver is unable to process medicines properly.
When people have both HIV and hepatitis B, this is often described as co-infection.
Many people don't notice any symptoms at all. Hepatitis B might only be diagnosed through routine health monitoring.
However, when you first become infected with hepatitis B, you may develop the following symptoms:
Symptoms usually last between one and three months (known as 'acute' hepatitis B). Most people with acute hepatitis B will clear the virus themselves and become immune. If this doesn't happen, the infection becomes chronic.
Early in the infection, most people will clear the virus without treatment and develop protective immunity. However, in about 5-10% of adults, hepatitis B continues to reproduce in the body long after infection. These people become chronically infected with hepatitis B, meaning that they continue to be infectious - although they may not experience any symptoms at all, or not for many years.
People living with HIV, especially if they have a low CD4 cell count, are less likely to clear the virus naturally than people without HIV.
Without treatment, some people with chronic hepatitis B eventually develop cirrhosis of the liver. About one in 20 people with cirrhosis will go on to develop cancer of the liver.
Everyone with HIV should have regular tests to monitor the health of their liver. These tests are especially important if you have hepatitis B - if so, doctors will closely monitor your liver function using blood tests.
Ultrasound examinations may also be performed, particularly if your liver shows signs of damage. Another test, called a FibroScan, can also test the liver for cirrhosis or fibrosis.
Sometimes, people also need a liver biopsy, where a tiny piece of tissue from the liver is removed for investigation.
Hepatitis B is passed on by contact with:
It's easily passed on:
It can also be passed on through:
Hepatitis B is many times more infectious than HIV and it can survive outside the body in dried blood for at least a week.
Hepatitis B can be avoided by:
If you're living with HIV, do not have hepatitis B, and a test shows that you do not have natural immunity against hepatitis B, you should be vaccinated.
People living with HIV can lose their immunity to hepatitis B if their immune system weakens, and should have their level of immunity checked regularly to see whether they need a booster dose of the vaccination.
There is a combined vaccination for hepatitis A and hepatitis B, however it might be less effective than the separate vaccinations for people who have a low CD4 count or a detectable viral load. Ask your clinician which would be most suitable for you.
You should be tested for hepatitis B soon after your HIV diagnosis, to see if you have been infected with the hepatitis B virus. This is done through a blood test.
In the UK, pregnant women are screened for hepatitis B. Babies born to mothers with hepatitis B can also be vaccinated soon after birth to prevent the infection being passed on to them.
Doing the following can help you look after yourself:
Yes. People with HIV are now recommended to start HIV treatment when they are diagnosed with HIV, regardless of their CD4 count. The same applies to people who are co-infected with hepatitis B and HIV.
You will take HIV treatment that includes drugs which are effective against hepatitis B as well. The British HIV Association (BHIVA) recommends that tenofovir-DF or tenofovir-AF (a newer formulation of tenofovir) and emtricitabine are used. The type of tenofovir you're prescribed will depend on whether you have any issues with bone density loss or kidney problems.
Some people may also need to take alpha interferon which is taken through injections.
You can call our free helpline THT Direct on 0808 802 1221 for a referral to a clinic.
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This article was last reviewed on
by Anna Peters
Date due for the next review: 30/11/2020
Content Author: S. Corkery (NAM)
Current Owner: Kerri Virani
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