Learn More About Hepatitis B

What is Hepatitis B?

Hepatitis B is a disease that affects your liver. It is caused by a virus, called the hepatitis B virus. “Hepatitis” means inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected. In the United States, approximately 1.2 million people have chronic Hepatitis B.


Why should I get tested for hepatitis B?

Testing is the best way to determine whether or not a person has Hepatitis B. Many people with Hepatitis B do not know they are infected since they do not look or feel sick. Learning if one is infected is key to diagnosing Hepatitis B early and getting appropriate medical care. Testing can also identify at-risk household members and sexual partners who, if uninfected, can then be vaccinated to protect them from getting Hepatitis B.


Who should get tested for Hepatitis B?

Testing for Hepatitis B is recommended for certain groups of people, including:

  • People born in Asia, Africa, and other regions with moderate or high rates of Hepatitis B
  • Unvaccinated people whose parents are from regions with high rates of Hepatitis B
  • Anyone having sex with a person infected with Hepatitis B
  • People who live with someone with Hepatitis B
  • Men who have sexual encounters with other men
  • People who inject drugs
  • All pregnant women
  • People with HIV infection
  • People on hemodialysis
  • People who receive chemotherapy or other types of immunosuppressive therapy


How does Hepatitis B affect the liver?

Of those with chronic hepatitis B as many as 60% or more remain have no symptoms or problems with the liver or other organs despite having the virus in their body. The only way these people will know that they have hepatitis B is if they have a blood test to look for evidence of the virus or the immune system’s reaction to it. It is important to remember that these people can still pass the virus on to others even if they do not know they have it. The remaining 30–40% of people with chronic infection will eventually (often after many years) develops liver inflammation or cirrhosis.  In these cases, symptoms may vary in severity and some people have significant liver damage without symptoms.


What are the symptoms of hepatitis B?

Many people with chronic Hepatitis B do not have symptoms and do not know they are infected. Even though a person has no symptoms, the virus can still be detected in the blood. Symptoms of chronic Hepatitis B can take up to 30 years to develop. Damage to the liver can silently occur during this time. When symptoms do appear, they are similar to acute infection and can be a sign of advanced liver disease. Not everyone has symptoms with acute Hepatitis B. Most adults have symptoms that appear within 3 months of exposure. Symptoms can last from a few weeks to several months and include:


  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Grey-colored stools
  • Dark urine
  • Joint pain
  • Jaundice

How did I get hepatitis B?

Hepatitis B is usually spread when blood, semen, or other body fluids from a person infected with the Hepatitis B virus enter the body of someone who is not infected. This can happen through sexual contact with an infected person or sharing needles, syringes, or other injection drug equipment. Hepatitis B can also be passed from an infected mother to her baby at birth.

Hepatitis B is NOT spread through breastfeeding, sharing eating utensils, hugging, kissing, holding hands, coughing, or sneezing. Unlike some forms of hepatitis, Hepatitis B is also not spread by contaminated food or water.


Why do I need to go to a doctor?

To best manage hepatitis B, the disease should be monitored by a doctor. This monitoring means having regular check-ups with your professional healthcare team to assess your hepatitis B infection.  Every 3–6 months, according to your doctor’s advice, you will have tests to check how much of the virus you have in your blood, how your liver is functioning, and how well your body is fighting the virus. How often you are monitored will depend on individual factors such as, how long you have had the infection, how severely your liver has been affected, how well you are family medical history.


Your doctor will evaluate your overall health and may do additional tests to check your liver. There are several different tests your doctor may order:

  • Liver function tests, also called a liver panel, to tell how well your liver is working. One of the most common tests is called ALT. The ALT levels are often, but not always, higher in people with hepatitis.
  • An ultrasound exam to create a visual image of your liver.
  • A liver biopsy, which is removal of a tiny bit of your liver, to allow your doctor to look directly at the health of the liver.
  • A viral load test which determines how much virus you have in your body.


Can Hepatitis B be cured?

There is no cure for hepatitis B and it is likely that you will need to be monitored for the rest of your life. Regular testing will allow your doctors to see if there are any changes in the functions of your liver, or the levels of virus in your blood. This will help them decide when you should start treatment and what the best possible course of therapy will be.


How can I protect others from getting hepatitis B?

Hepatitis B is usually spread when blood, semen, or other body fluids from a person with the Hepatitis B virus enter the body of someone who is not infected. The virus is very infectious and is transmitted easily through breaks in the skin or mucus membranes (nose, mouth, eyes and other soft tissues).

To protect others from getting hepatitis B, follow these rules:

  • If having sex, ALWAYS use a condom
  • Do not donate blood, semen or register as an organ donor
  • Do not use anyone else’s toothbrush, razor, scissors or other personal grooming equipment or let them use yours
  • Clean surface blood spills with a solution of 1 part bleach to 10 parts water or hot soapy water. Bag and seal blood-stained articles before placing them in the main bin.
  • Adhere to local infection control standard precautions in the healthcare setting.
  • Always clean and cover cuts, scratches, and open wounds with a waterproof plaster.
  • Sexual partners, children and other household members of an acute/chronically hepatitis B infected individual should be vaccinated against hepatitis B. This is given by injection as 3 separate doses.


Who should get vaccinated against Hepatitis B?

Vaccination is recommended for certain groups, including:

  • Anyone having sex with an infected partner
  • People with multiple sex partners
  • Anyone with a sexually transmitted disease
  • Men who have sexual encounters with other men
  • People who inject drugs
  • People who live with someone with Hepatitis B
  • People with chronic liver disease, end stage renal disease, or
  • HIV infection
  • Healthcare and public safety workers exposed to blood
  • Travelers to certain countries
  • All infants at birth


How can I keep hepatitis B from causing serious damage to my liver?

People with chronic Hepatitis B should see a doctor regularly. They also should ask their health professional before taking any prescription or over-the-counter medications—including herbal supplements or vitamins—as they can potentially damage the liver. People with chronic Hepatitis B should also avoid alcohol since it can accelerate liver damage.

Here are some important tips to keep your liver healthy:

  • Do not drink alcohol. Alcohol damages your liver even when you are healthy. Drinking alcohol when you have hepatitis B makes the damage much worse. Remember, there is no “safe” amount of alcohol you can drink when you have hepatitis B. It does not help to switch from “hard” liquor to beer, cider, or wine. If you need help to stop drinking alcohol, talk with your doctor.
  • Get vaccinated against other hepatitis viruses. Having hepatitis B does not mean that you can’t get other kinds of hepatitis. Talk to your doctor about getting vaccinated (or shots) to protect you from hepatitis A.
  • Avoid taking medicines, supplements, or natural or herbal remedies that might cause more damage to your liver. Even ordinary pain relievers can cause liver damage in some people. Check with your doctor before you take any natural or herbal remedy, supplement, prescription, or non- prescription medicine.
  • Ask your doctor about tests to see if your liver has already been damaged by hepatitis B. These tests might include a liver biopsy, a medical procedure that allows your doctor to look at a very small part of your liver for signs of trouble.
  • Ask your doctor about treatments. Find out more about these treatments, and discuss any questions with your doctor.
  • Get involved with organizations or support groups for hepatitis B in your area. If you need help finding one, ask your doctor for a list of local resources.


How is chronic Hepatitis B treated?

Not all those infected with Hepatitis B require treatment, only those with persistently high levels of the virus in their blood and evidence of the infection affecting the liver. Treatment does not cure hepatitis B, but by suppressing the virus, works to delay or even prevent complications developing, such as liver damage and cirrhosis. Antiviral drugs are commonly used and these drugs work by stopping the hepatitis B virus from multiplying in the body.

Current available medications for treatment of hepatitis B:

  • Adefovir (Hepsera)
    • Dose: 10mg once daily
    • Common side effects: headache, diarrhea, weakness, blood in urine
  • Entecavir (Baraclude)
    • Dose: 0.5mg to 1mg daily
    • Common side effects: edema, headache, fatigue
  • Tenofovir (Viread)
    • Dose: 300 mg once daily
    • Common side effects: headache, insomnia, pain, dizziness, depression
  • Pegylated Interferon
    • Once weekly injection
    • Common side effects: flu-like symptoms, headache, fatigue, depression