Definition

Hepatitis B is a liver disease. It can be acute or chronic. Acute hepatitis B usually goes away on its own and may not need treatment.

Chronic hepatitis B is an infection that lasts more than 6 months. Chronic infection can lead to other health problems. Hepatitis B is treated with antiviral medications.

Causes

Hepatitis B is caused by a virus. The virus causes swelling and irritation in the liver and makes it difficult for the liver to function normally.

The hepatitis B virus (HBV) is spread by semen, vaginal secretions, saliva, blood, or body fluids from an infected person. The virus can pass from these fluids to your body through an open cut in your skin.

A woman with hepatitis can also pass HBV to her baby during childbirth.

Risk Factors

Factors that may increase your chance of getting hepatitis B include:

• Illicit drug injection use, especially when sharing needles
• Unprotected sexual contact, especially with multiple partners
• Sharing a residence and/or personal items with someone who has HBV
• Stay in hospital or long-term care facility
• Hemodialysis treatment
• Work that includes contact with blood or body fluids, such as health care or public safety workers
• Travel to areas where HBV is common

Symptoms

It is possible that someone infected with HBV may never have symptoms of hepatitis B.

If symptoms do develop, they appear around 60-150 days after exposure. Hepatitis B may cause:

• Fatigue that lasts for weeks or months
• Loss of appetite
• Nausea or vomiting
• Low-grade fever
• Jaundice —a yellowing skin and eyes
• Abdominal pain in the upper right side of the abdomen
• Joint pain
• Dark urine and light-colored stool

Chronic hepatitis can lead to serious health problems including:

• Cirrhosis
• Liver cancer
• Liver failure
• Death

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Hepatitis B is diagnosed with blood tests. Blood tests are also used to monitor changes in the liver.

For chronic cases, a liver biopsy may be needed.

Treatment

Acute infection may not need any treatment since it usually goes away on its own.

Chronic hepatitis B may be treated with a combination of different antiviral medications. All medications do not work the same in all people. Talk with your doctor about the best treatment plan for you.

Your doctor may also ask that you:

• Avoid alcohol
• Avoid certain medications, dietary supplements, and herbs
• Contact recent sexual partners so they can be tested and/or treated

Prevention

There is a vaccine for hepatitis B that is available for adults. This vaccine is usually given as a series of three injections. In addition, the vaccine is routinely given to newborns. Children and teens who were not vaccinated as babies can still receive the shots.

Other prevention strategies include:

• Use condoms regularly or abstain from sex.
• Limit your number of sexual partners.
• Do not inject drugs. If you use IV drugs, get treatment to help you stop. Never share needles or syringes.
• Do not share personal items that may have blood or body fluids on them.
• Make sure a tattoo artist or piercer properly sterilizes the equipment.
• Wear gloves when touching or cleaning up body fluids on personal items.
• Cover open cuts or wounds.
• If you are pregnant, have a blood test for hepatitis B. Infants born to mothers with hepatitis B should be treated within 12 hours after birth.
• Go to regular check ups and get tested for hepatitis B and other sexually transmitted diseases (STDs) as advised.

Hepatitis B Foundation http://www.hepb.org

Health Canada http://www.hc-sc.gc.ca

Hepatitis B. American Liver Foundation website. Available at:
http://www.liverfoundation.org/abouttheliver/info/hepatitisb
Updated February 17, 2012. Accessed February 13, 2014.

Hepatitis B information for health professionals. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/hepatitis/HBV
Updated May 16, 2012. Accessed February 13, 2014.

Hepatitis B virus (HBV). EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated February 4, 2014. Accessed February 13, 2014.

Vaccine information statement: hepatitis B vaccine. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/vaccines/hcp/vis/vis-statements/hep-b.pdf
Updated June 18, 2013. Accessed February 13, 2014.

Workowski KA, Berman S, et al. Sexually transmitted diseases treatment guidelines, 2010. MMWR. 2010;59(No. RR-12):1-110.

10/8/2014 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
British Association of Sexual Health and HIV (BASHH) recommendations on testing for sexually transmitted infections in men who have sex with men. Available at: http://www.bashh.org/documents/BASHH%20Recommendations%20for%20testing%20for%20STIs%20in%20MSM%20-%20FINAL.pdf. Updated 2014. Accessed October 8, 2014.