Hepatitis B

Many people who get hepatitis B notice no symptoms or they are so mild that they may not realise they have it. But weeks or months after infection it can cause mild flu-like symptoms.

You may get diarrhoea, feel sick or very tired, have itchy skin and stomach pain. You may get jaundice, meaning your skin and the whites of your eyes turn yellow, your urine is dark and your faeces (poo) are pale.

Symptoms can last several weeks, taking months to get back to normal. Most people make a full recovery but up to one in 10 become ‘carriers’ with chronic (long term) infection. They feel fine but stay infectious to others, with a small risk of going on to develop liver disease.

Around one in a 100 people get a more serious illness which can be fatal if not treated immediately.

You are most infectious to others in the two weeks before symptoms show. In men, the virus can be passed on in these body fluids: blood, semen and pre-cum.

During sex between men it is passed on through: 

• oral or anal sex without a condom 
• rimming.

The virus can also spread through sharing injecting drug equipment such as needles and syringes which can carry infected blood. It can be found in saliva but there are no proven cases of kissing passing it on -infections from bites are rare.

Protect yourself and others

You can protect yourself by getting a vaccination. People at higher risk of hepatitis B are recommended to have a vaccination, these include gay and bisexual men. You might be able to get vaccinated for free by your GP or some sexual health clinics. The vaccine protects you for 10 years or longer - there is a vaccine which can protect you against both hepatitis A and B.

If you have hepatitis B tell people you live with or recently had sex with to urgently ask their doctor about vaccination. Avoid sex until told you are no longer infectious.

Although not as good as being vaccinated these also cut the risk: 

• using condoms for penetrative sex 
• using a latex barrier (like a condom cut into a square) for rimming.

If you are a ‘carrier’ you may want to tell a partner and explain you are infectious. They can then decide if they want to take precautions (eg, get vaccinated) or are happy to take any risk. That way they cannot accuse you of infecting them without them knowing the risk was there.

What can I do if I think I have hepatitis B?

Most cases are diagnosed by GPs (family doctors), not sexual health clinics and treatment isn’t needed for most people. If you had sex with someone recently or share your house with others they can be vaccinated to stop them getting the infection - they should see a doctor straight away. Avoid sex until told you are no longer infectious.

Testing

A blood test will confirm whether you have the virus.

Treatment

In most cases no treatment for hepatitis B is needed, other than rest. You may need several weeks off work and will be advised to avoid alcohol until your liver recovers. Smokers often avoid smoke as it can make them feel sick. Recreational drugs should be avoided to allow your liver to get better. Once you have had the infection you’re immune and can’t get it again, but you can get other types of hepatitis.

Drugs are available for ‘carriers’. A small number of ‘carriers’ go on to get liver disease (and a small number of those get liver cancer) and may need a liver transplant.

Why get treated?

If someone becomes a ‘carrier’, drugs can limit liver damage and make it less likely they pass the virus on.