Hepatitis B is similar to hepatitis A in its symptoms, but is more likely to cause chronic long-term illness and permanent damage to the liver if not treated.

Symptoms

Many people who become infected with HBV experience mild symptoms or no symptoms at all, but they may still carry the infectious virus and pass it on to others. When symptoms do appear they are similar to those of hepatitis A and may include:

• loss of appetite.
• weight loss.
• a short, mild, flu-like illness.
• nausea, vomiting and diarrhoea.
• jaundice (yellow skin and whites of eyes, darker yellow urine and pale faeces).
• itchy skin.

Most adults infected with the hepatitis B virus fully recover and develop life-long immunity.

If a person lives with hepatitis B infection for a number of years then they may develop the following complications:

• chronic hepatitis.
• liver cirrhosis.
• liver cancer.

How It’s Passed On

The hepatitis B virus (HBV) is very common worldwide, with more than 350 million people infected. Those with long term HBV are at high risk of developing liver cirrhosis or liver cancer.

Hepatitis B is most frequently passed on through the exchange of bodily fluids with an infected person. HBV can be spread in the following ways:

• by unprotected (without a condom) penetrative sex (when the penis enters the anus, vagina or mouth) with someone who is infectious. Also by sex that draws blood with someone who is infected.
• by sharing contaminated needles or other drug-injecting equipment.
• by using non-sterilised equipment for tattooing, acupuncture or body piercing.

Hepatitis B cannot be spread through sneezing, coughing, hugging or coming in contact with the faeces of someone who is infected.

Getting Help

If you have any symptoms or you are worried you may have been infected with hepatitis B, you should discuss your worries with a doctor.

What Does a Positive Test Result Mean?

A positive test result could indicate either of the following:

• A past infection. This means the patient has already been in contact with hepatitis B and their immune system has succeeded in fighting off the virus. The patient will then have a natural immunity to the virus.
• The patient is a carrier. This means the patient is carrying HBV and can pass it on to others. The person may not display any symptoms but could be at risk of developing chronic liver disease.

What Does a Negative Test Result Mean?

This result generally means the patient has never been infected with HBV and therefore has no natural immunity against the virus. If the person suspects they may have been recently exposed to HBV, the doctor may advise them to take a repeat test to confirm their negative status, and may also advise immunisation against hepatitis B.

Treatment

A patient with a positive test result will be referred to a specialist who will carry out further tests to determine the degree to which hepatitis B may be affecting the liver, and what may be the best treatment options. In these tests a small sample of liver tissue may need to be taken (a liver biopsy).

In the majority of patients with active HBV, symptoms will not be severe and treatment will not be required. The patient will be monitored and after a few months the patient’s immune system should fight off the virus, giving the patient natural immunity.

Regardless of whether the infection is producing symptoms or not, the patient will be advised to avoid alcohol, get plenty of rest and maintain a healthy diet.

Immunisation

Three immunisation injections are given over a period of 3-6 months. A blood test is taken once the course of injections is completed to check that they have worked. Immunity should then last for at least 5 years.

Follow Up

A patient with an active infection will be advised to have regular blood tests and physical check-ups to monitor the virus, even if they are not receiving treatment. All carriers of HBV should expect to be referred to specialist services.

The doctor or nurse may advise the patient to avoid alcohol, fatty foods and follow a low-salt diet. It is most important to use a condom for penetrative sex to prevent passing on the virus. Sexual partners of the patient should be tested and immunised against HBV (if not already infected).