Hepatitis B
- What is Hepatitis B
- How is it diagnosed
- What are the symptoms
- How is it spread
- How is it prevented
- Who is at risk and should get vaccinated
- Who should not be vaccinated
- Other ways to prevent the spread of Hepatitis B
- What you can do to take care of yourself
- Treating Hepatitis B
- Hepatitis B and pregnancy
- More information & resources
What is Hepatitis B
Hepatitis B is a virus that can cause liver cancer and can be prevented through a vaccine. Hepatitis B can cause short-term (acute) or long-term (chronic) infection in the liver. Chronic infection can lead to scarring of the liver, also known as cirrhosis, or can lead to liver cancer. Approximately 1.25 million people in the United States have chronic hepatitis B infection.
How is Hepatitis B diagnosed
Hepatitis B is diagnosed with a blood test. The test looks for different antibodies in your blood. The presence of these antibodies can tell your doctor or healthcare provider if you have been exposed to hepatitis B, if you have a chronic infection, or if you have previously received the hepatitis B vaccine.
What are the symptoms of Hepatitis B infection
Symptoms can include appetite loss, fatigue, low-grade fever, muscle and joint aches, nausea and vomiting, pale colored stools (grey/clay colored), dark urine, and/or jaundice (yellowing of the skin or whites of the eyes).
A person with an acute infection may not show symptoms for 2 to 5 months after the time of infection, or may never show symptoms. On average, the symptoms first occur about 3 months after exposure. They usually last for several weeks but can last for up to 6 months.
Chronic infection may have no symptoms or may cause severe inflammation of the liver. This can lead to cirrhosis (scarring) over several years, or even liver cancer.
How is Hepatitis B spread
When someone has hepatitis B the virus is in the blood or body fluids (semen and vaginal fluid). The virus can be spread when blood or body fluid from an infected person enters the body of a person who is not immune.
The hepatitis B virus is 100 times more infectious than HIV and can survive outside the body for at least 7 days and still be able to cause infection.
Activities that can expose someone to hepatitis B include:
- Having sex with someone who has hepatitis B
- Sharing needles, syringes or drug preparation equipment
- Contact with blood or open sores of an infected person
- Sharing household items (razors, toothbrushes, nail clippers, and tweezers)
- Being born to a hepatitis B positive mother
- Exposure to infected blood in any situation can be a risk for transmission
Hepatitis B virus is not spread through food, water, kitchen utensils, breastfeeding, kissing, coughing, or sneezing.
How is Hepatitis B prevented
Vaccination is the best prevention. Vaccination is recommended for infants at the time of birth, for children under the age of 19 who have not been vaccinated, all at-risk adults, and anyone who wants to be protected.
The vaccine is given in 3 doses – the first 2 doses are given one month apart and the final dose is given 6 months later. It provides long-term immunity against the hepatitis B virus.
Who is at risk and should get vaccinated
- Anyone who wants protection from hepatitis B
- All children and teens ages 0-18 years
- Household contacts of chronically (life long) infected persons
- People who are sexually active, especially with multiple sex partners
- Immigrants and their children from areas with high rate of hepatitis B
- Injection drug users
- Anyone who has been diagnosed with a sexually transmitted disease at any time in his/her life
- People who are HIV +
- Men who have sex with men
- Healthcare and public safety workers who might be exposed to blood or body fluids
- International travelers to regions where hepatitis B is common
- People with chronic liver disease
- People with sever kidney disease / hemodialysis patients
The hepatitis B vaccine is available through all primary care providers. Individuals who do not have a doctor or are uninsured should call one of the local District Offices of the Vermont Department of Health for more information.
Who should not be vaccinated?
Anyone who has a life threatening allergy to baker’s yeast or any other component of the vaccine should not be immunized.
Anyone who has had a life-threatening reaction to a previous dose of hepatitis B vaccine or anyone who is moderately or severely ill at the time of administration of the vaccine.
Talk to your healthcare provider.
Other ways to prevent the spread of Hepatitis B
- Practice safe sex
- Do not share needles, cocaine straws or any drug paraphernalia
- If you are infected, cover all sores and rashes and do not touch them
- Get tested if you are pregnant or want to become pregnant
- Do not share personal items such as razors, toothbrushes, nail clippers, or tweezers.
- Use properly sterilized needles and equipment for tattoos and body piercing
- Get tested if you think you may have been exposed
- Tell you doctor, dentist and other healthcare providers if you have been exposed to hepatitis B
- If exposed, do not donate blood, organs or tissue
- Clean any blood spills with a 10% solution of household bleach and water
- People with hepatitis B should not pre-chew food for babies
What you can do to take care of yourself
- Avoid alcohol and smoking as well as acetaminophen and other medications that include acetaminophen, as they can be hard for the liver to process
- Talk to your provider before using any prescription, over the counter medication or herbal remedies
- Be sure to eat a well-balanced diet that is low in fat and includes plenty of fruits and vegetables
- Avoid eating raw shellfish as it may contain bacteria and viruses that are harmful to the liver
- If you have hepatitis B you should also get the vaccine against hepatitis A. If you get more than one kind of hepatitis at once it can be very bad for your liver and can increase your chance of liver damage and liver cancer
What is the treatment for Hepatitis B?
Acute hepatitis B
There is no medication that will cure the virus. Recommended treatment is bed rest, drinking lots of fluids, eating a healthy diet and avoiding alcohol. It is very important to see a doctor regularly during this time to make sure that your body has fully recovered and that the virus is not progressing. Most people will recover from the virus after six months and have lifelong immunity.
Among adults who are exposed to hepatitis B, 90% clear the infection within six months and will not develop chronic infection.
However, among infants and children who are exposed, only 10% will clear the infection. Ninety percent of infants and children who are exposed will become chronically infected, and may go on to develop cirrhosis or liver cancer.
Chronic hepatitis B
Not everyone with chronic hepatitis B needs medication. A doctor or liver specialist can tell you whether you would benefit from taking medication for your hepatitis B infection.
Current medications for hepatitis B do not cure the virus, but they can limit the damage to your liver and lower the chance that you will develop scarring or liver cancer. When on the medications, patient must be monitored by a doctor because there are side effects. If you have hepatitis B, you should talk to a doctor and have routine evaluations and liver screenings every 6-12 months.
Hepatitis B medications should not be taken if pregnant. Pregnant women should let their doctor or healthcare provider know if they have hepatitis B so their baby can receive treatment immediately after birth to prevent the baby from getting the virus.
Hepatitis B and Pregnancy
Are pregnant women tested for hepatitis B?
Yes, when a woman comes in for prenatal care she will be tested for hepatitis B. This test is important because women infected with hepatitis B can pass the virus to their babies during birth. There are medications that can keep babies from getting hepatitis B during birth if their mother has the virus.
What happens if I have hepatitis B and I’m pregnant?
If a woman tests positive for hepatitis B during her pregnancy, the local District Office of the Vermont Department of Health will be notified, as will the Perinatal Hepatitis B Coordinator who notifies the hospital. They will help make sure that the woman and her baby receive the proper education, medication and vaccination to prevent the spread of hepatitis B during the birth.
Can a baby be protected from getting hepatitis B from his or her mother during birth?
Yes, babies can be protected from hepatitis B through medication and vaccination.
Within 12 hours after birth the baby will receive a shot of a medication called Hepatitis B Immunoglobulin (HBIG) and the first shot of the hepatitis B vaccine series. These will help the baby fight off the hepatitis B virus and prevent this infection. The baby will receive the other two shots of the vaccine series at one month and six months after birth
Do babies need the hepatitis B vaccine even if a pregnant woman does not have hepatitis B?
Yes. The hepatitis B vaccine is recommended for all infants at birth.The US Centers for Disease Control and Prevention (CDC) recommends that infants get the first shot before leaving the hospital, and continue with their doctor, to receive the rest of the series.
Hepatitis B vaccine is recommended for all babies so that they will be protected from a serious but preventable disease. Unvaccinated infants and children who are exposed to hepatitis B have a 90% chance of having a lifelong infection, compared to adults who are exposed who have a 10% chance of lifelong infection. Infants and children who have hepatitis B can become very ill. This can eventually lead to serious long term health problems, including liver damage, liver cancer, and even death.
More Information & Resources
Centers for Disease Control and Prevention
- Information for the Public
- Information for Health Care Providers
- Fact Sheets
- Vaccination Information
American Liver Foundation
International Hepatitis Foundation
New York State Department of Health