Hepatitis B

Hepatitis B is an infection caused by the Hepatitis B virus (HBV), a virus that affects the liver. The
hepatitis B virus can be passed on via the blood and through sexual contact. A blood test will show
whether or not a person has hepatitis B.
WARNING: If you suspect you have a Sexually Transmitted Infection (STI), don't give it to others –
get tested and treated quickly.

How is hepatitis B passed on?

Hepatitis B is a highly infectious virus, which is spread through contact with blood or blood products, or by
intimate contact such as sexual intercourse (heterosexual and homosexual).
The ways that it is spread include:

• sharing injecting equipment (injecting drug users)

• needle-stick injury (when a needle or other surgical instrument containing blood of a
person who has hepatitis B pierces the skin of another person) - this can be occupational
(at work) or accidental (eg. a needle left on the ground)
• body-piercing and tattooing
• sexual intercourse (heterosexual and homosexual)
• from a mother to a newborn baby, usually at or around the time of birth
• child-to-child spread, usually through contact with bleeding sores
• breastfeeding (though the amount of virus in breast milk is very low).

It is not spread through food or water or through ordinary social contact.

Effects
About 50% of adults and 90% of young children have no symptoms at all, while others become ill at least
7 weeks after exposure with some or all of the following symptoms.

• Loss of appetite
• Fever
• Turning yellow (mostly in the skin and whites of the eyes) – this is called jaundice
• Feeling sick (nausea) and vomiting
• Lack of energy
• Sin rashes and joint pains.

These symptoms can last for several weeks or months.

Most people who become sick recover from the illness, and no longer carry the virus, so they can no
longer pass it on.
Carriers

• Some people become carriers – they do not get ill after they are infected, and they do
not get rid of the virus from their bodies, so they can pass it on.
• Carriers might not even know they ever had hepatitis B – the only way to tell is through
a blood test.
• Carriers are at higher risk of chronic liver disease (cirrhosis, or a rare cancer of the liver)
later in life.
• Most babies and young children who are infected with hepatitis B become carriers.

Hepatitis D

• Hepatitis D virus (HDV) is the smallest known animal virus and it cannot cause infection
unless Hepatitis B virus is also present.
• If a person is infected with hepatitis D at the same time as being infected with hepatitis
B, the person is more likely to become very ill, and then become immune to both viruses
(a co-infection).
• If someone with chronic hepatitis B is infected by hepatitis D, he can have a severe
illness with ongoing liver damage and an early death (this is called a super-infection).
• HDV is not common in Australia.
• See the topic 'Hepatitis D' for more information.

Immunisation
Immunisation against hepatitis B is very safe and very effective. Babies need 4 doses, while older children
and adults are usually given 2 or 3 doses, by injection, depending on the age and the vaccine used.
The Immunise Australia program provides free immunisation for:

• All babies, starting on the day that they were born.

• Children between 10 and 13 years of age (usually at school, during year 7 or 8).

Other high-risk communities and individuals for whom immunisation is recommended (for whom the
vaccine may or may not be free) include:

• Babies and children of community groups with high carrier rates, such as some
Australian Aboriginal communities and South-East Asian groups in Australia
• Sexual and household contacts of people with hepatitis B
• People who work where they may be exposed to hepatitis B (eg. Health-care workers,
embalmers, tattooists, body-piercers)
• Injecting drug users
• Men who have sex with men
• Sex workers
 • Staff in corrective services, such as detention centres and jails
• Adults with increased risk, such as those having dialysis, who are HIV-positive, or who
have serious illnesses which affect the function of their immune system
• People travelling to certain overseas locations.

Any person can be immunised at any age, even if the person is not in one of the high-risk groups, and it is
recommended that all people be protected against Hep B by immunisation. Talk to your doctor or health
worker about arranging immunisation.

Protecting yourself

• Avoid exposure to the blood of others, especially of people you don't know, or who may
be in one of the high-risk groups for exposure to hepatitis B. Remember also that people
who are hepatitis B carriers may not know that they carry the virus. They may not have
had any symptoms at all.
• Ways to avoid blood contact:
o Do not share any injecting equipment, including needles and syringes, spoons,
swabs, filters and tourniquets
o Don't share razors, toothbrushes or even combs, anything that could carry and
hold a speck of blood
o If you are having a piercing or tattoo, ensure that the worker uses sterile
techniques. Ask questions – do they use new sterile disposable needles? Do
they sterilise all equipment? Has the worker completed a health department
approved sterilisation course? Look around – is the place clean? Can you see
the special yellow sharps disposal units – this gives an indication that the
worker follows health standards.
o If you are helping a person who is bleeding, encourage them to wash the blood
off their skin and put on a waterproof dressing. If they cannot manage without
help, cover your hands with plastic gloves (or plastic bags if you don't have
gloves).
• Use condoms for safer sex. (For more information, see the topic Safer sex ).
• It is not necessary to keep people with hepatitis B away from others.

The blood rule

• Many sports have adopted a rule which must be followed if a player is wounded and
bleeding during a game, because of concerns about the spread of blood-borne infections
such as hepatitis B.
• The rule may require players who are bleeding or who have blood on themselves or their
uniform to leave the ground and have the problem seen to. The player may not be
allowed to return until the bleeding has ceased, the wound covered by a waterproof
dressing and any blood completely removed.
 • Hepatitis B and hepatitis A protection by immunisation is highly recommended for people
playing contact sports.

Testing
A blood sample is used to test for hepatitis B. The test can show if you are unwell because of hepatitis B,
whether you have had hepatitis B or whether you are a carrier.

Treatment

• There is no cure for hepatitis B.

• Most people who have been unwell recover after several weeks, sometimes a few
months. Their immune system gets rid of the virus, and they will not get a hepatitis B
infection again.
• It is important to rest, eat a healthy diet and avoid alcohol to assist recovery from
hepatitis B.
• If the person is a carrier and develops chronic hepatitis B, liver function tests should be
done regularly.

If their liver is damaged, some medication (such as Interferon) may be useful, and in rare cases they may
require a liver transplant if they develop liver failure.