Hepatitis B 

Introduction 

The liver

Your liver is your body's "factory", carrying out hundreds of jobs that are vital for life, including:

  • storing glycogen (carbohydrate that produces short-term energy)
  • making bile, which helps to digest fats
  • making substances that clot the blood
  • processing and removing any alcohol, toxins and drugs

You only have one liver, but it's very tough. It keeps going even when badly damaged, and it can keep repairing itself until it is severely damaged.

Hepatitis B is a type of virus that can infect the liver.

Symptoms can include:

  • feeling sick
  • being sick
  • lack of appetite
  • flu-like symptoms, such as tiredness, general aches and pains, and headaches
  • yellowing of the skin and eyes (jaundice)

However, many people don't realise they have been infected with the virus because the symptoms may not develop immediately, or even at all.

It takes between 40 and 160 days for any symptoms to develop after exposure to the virus.

Read more about the symptoms of hepatitis B.

How does hepatitis B spread?

Hepatitis B can be spread through blood and body fluids such as semen and vaginal fluids, so it can be caught:

  • during unprotected sex, including anal and oral sex
  • by sharing needles to inject drugs such as heroin

Hepatitis B in pregnancy

A mother can also pass on the hepatitis B infection to her newborn baby, but the infection can be prevented if the baby is vaccinated immediately after birth.

Read more about hepatitis B in pregnancy.

In England, people who are most at risk of contracting hepatitis B include:

  • people who inject drugs
  • people who change sexual partners frequently

Read more about the causes and risk factors for the hepatitis B infection.

How is it diagnosed?

Hepatitis B is diagnosed by a blood test that shows a positive reaction to hepatitis B surface antigen (the outer surface of the hepatitis B virus that triggers a response from your immune system).

A positive result means your liver is releasing hepatitis B protein into your blood, which suggests chronic infection.

Your GP may also request a liver function test. This is a blood test that measures certain enzymes and proteins in your bloodstream, which indicates whether your liver is damaged. It will often show raised levels if you are infected with the hepatitis B virus.

Stages of infection

In most cases, the hepatitis B virus will only stay in the body for around one to three months. This is known as acute hepatitis B.

In around 1 in 20 cases in adults, the virus will stay for six months or longer, usually without causing any noticeable symptoms. This is known as chronic hepatitis B.

Chronic hepatitis B is particularly common in babies and young children: 9 in 10 children infected at birth and around 1 in 5 children infected in early childhood will develop a long-term infection.

People with chronic hepatitis B can still pass the virus on to other people, even if it is not causing any symptoms.

Around 20% of people with chronic hepatitis B will go on to develop scarring of the liver (cirrhosis), which can take 10 to 20 years to develop, and around 1 in 10 people with cirrhosis will develop liver cancer.

Read more about complications of hepatitis B.

How is it treated?

There is currently no specific treatment for acute hepatitis B, other than using painkillers to relieve symptoms.

Treatment for chronic hepatitis B depends on how badly your liver is affected. It can be treated using medications designed to slow the production of the virus and prevent damage to the liver.

Read more about the treatment of hepatitis B.

Can it be prevented?

There is a vaccine thought to be 95% effective in preventing hepatitis B. Because of the relative rarity of hepatitis B in England, the vaccine is not given as part of the routine childhood vaccination schedule.

Vaccination would usually only be recommended for people in high-risk groups, such as:

  • people who inject drugs or have a sexual partner who injects drugs
  • people who change their sexual partner frequently
  • people travelling to or from a part of the world where hepatitis B is widespread
  • healthcare workers who may have come into contact with the virus

Pregnant women are also screened for hepatitis B. If they are infected, their baby can be vaccinated shortly after birth to prevent them also becoming infected.

Read more about hepatitis B vaccination.

Who is affected?

Hepatitis B is uncommon in England and cases are largely confined to certain groups, such as drug users, men who have sex with men, and certain ethnic communities (for example, South Asian, African and Chinese). There were 5,478 newly reported cases in England during 2011.

In contrast, hepatitis B is common in other parts of the world, particularly east Asia and sub-Saharan Africa. The World Health Organization estimates that hepatitis B is responsible for 600,000 deaths a year worldwide.

Outlook

The vast majority of people infected with hepatitis B are able to fight off the virus and fully recover from the infection within a couple of months.

Most people with chronic hepatitis B have very little liver damage. A small minority of people go on to develop cirrhosis of the liver and, in some cases, liver cancer.

It's therefore important to get yourself vaccinated if you fall into one of the high-risk groups for catching hepatitis B.

Page last reviewed: 02/06/2014

Next review due: 02/06/2016

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Comments

The 4 comments posted are personal views. Any information they give has not been checked and may not be accurate.

UKCanadian said on 21 May 2014

Hello, Bird On The Wire,

I'm sorry to hear of your loss. I would also like to help ease your mind re: your father.

I contracted Hep B as a young child while living overseas with my family. I actually didn't even know about it until my sister, who also had apparently contracted it as a child, had anti-bodies for Hep B show up in her first STI check. I went and had myself tested and found the same results.

Obviously, neither of us were sexually active, nor had we been exposed to unsterile needles (my parents brought supplies with us for any boosters we received while living in Vanuatu). Sometimes we just get exposed to the virus through day-to-day life.

I hope this helps.

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nimblefingers said on 04 May 2012

Hello, Bird On The Wire

I also lost my mother 4 years ago to Hepatitis B. She was 71 years of age and married to the same man for over 40 years.
The doctors were perplexed as to how she contracted the virus (due to age, no foreign travel etc).
I believe it was the result of keyhole surgery which left an open wound which would not heal for over 12 months several years ago. A lot of time was spent changing dressings in and out of the hospital.
The coroner wanted to investigate her death but I decided against it as she had been suffering from other serious health problems and it was only a matter of time, the Hepatitis B just sped things up.
Incidently, I had to be tested for the virus as I had been her sole carer, responsible for feeding and bathing her. The rest of the family were assumed not at risk and were not tested. Happily the result was negative.
I would advise you to go down the route of believing your father came into contact with the virus in an every day situation - all it takes is a small cut or wound and being in the wrong place at the wrong time.
Hope this helps to ease your mind.

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meao1980 said on 28 March 2012

Hi Bird on The Wire,

Soo sorry for the loss of your dad, but I thought I'd respond to your comment.

Like your dad I have never been an IV drug user or drug user (apart from alcohol) or had unprotected sex. I found out in a blood test that I had picked up Hep B but I was lucky enough to clear it.
I was told by the doc and hospital that it is very common and easy to pick up e.g. pricking your finger on a drawing pin which has the infection on (the virus can live outside the body for a week), he also asked me if I had travelled to a foreign country recently, so it is very possible your father picked it up whilst working in spain. I hope that puts your mind slighty at rest.

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Bird On The Wire said on 07 March 2012

I lost my dad in 1991 to cancer of the liver (he had a primary but when it was discovered nobody attempted to find it because he was diagnosed as terminal), he also had Hepatitis B, which supposedly aided the cancer in his liver. Now, my dad was married to my mum when he was diagnosed with both diseases, and he was never an IV drug user or a drug user of any kind. It has always perplexed me as to how he came by the Hep B, my mum says he probably got it when he was working as a chef in spain, but I am not so sure. It bothers me sometimes that he may have been having an affair, and that I may even have a half sibling somewhere as a result of that. I don't think my dad would ever have dreamed of doing this to my mum, it is purely speculation, but can you pick up Hep B in a kitchen? I really don't know, I would like to because it niggles me sometimes.

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