Hepatitis B (HBV)

What is it?

Hepatitis B is a virus that causes inflammation (swelling) of the liver and may result in liver disease that can persist (called chronic Hepatitis B). Over 26,000 indigenous Australians have chronic hepatitis B.

How do you get it?

Hepatitis B can be passed on by infected blood or semen (cum) through activities like unprotected sex and oral sex, sharing injecting equipment, toothbrushes or razors and tattooing and body piercing with un-sterile equipment. Hepatitis B is not passed on through sharing cutlery or food (unlike hepatitis A). Hepatitis B is common in some remote Aboriginal communities, and in these communities mother-to-child transmission and child-to-child transmission can occur.

What are the symptoms or signs?

Symptoms of hepatitis B infection may include:

• mild flu-like symptoms
• nausea and vomiting
• abdominal pain
• joint and muscle pain
• jaundice [yellowing of the skin, eyes or urine (pee)]

Symptoms can take between one and six months after infection to show up. Some people may have no symptoms at all. Hepatitis B can become a chronic infection (more than six months in duration). Most adults will recover completely from hepatitis B but a large number do not clear the infection. Those that do not clear the virus are at risk of developing cirrhosis and liver cancer.

Testing

Hepatitis B is diagnosed with a blood test. Once you have had hepatitis B antibodies will be detectable in your blood. Many people will become immune to hepatitis B once they have had the disease, meaning that it is unlikely that they will get it again. A large number do not clear the virus and their liver health needs to be regularly monitored with blood tests called liver function tests.

Can it be treated?

There is no cure for hepatitis B; however, people with chronic hepatitis B may be treated with anti-viral medications. These are specialised drugs so see your doctor and hepatitis specialist. There is no treatment for acute hepatitis B infection.

If you get chronic Hepatitis B stay in contact with your Aboriginal Medical Service (AMS) or GP, and have regular tests even if you feel well.  Talk to your doctor before taking any herbal or complementary medicines, as some are very harmful to the liver.  Exercise and eat a healthy diet to help you maintain a normal body weight and if possible avoid (or at least reduce) alcohol and tobacco use.

How can it be prevented?

There is a vaccination course (injections) available for hepatitis B. Three doses of the vaccination are required with an interval of one to two months between the first and the second dose, with a third dose at two to five months after the second dose. There is also a hepatitis A and B combination vaccination available.

To reduce the risk of transmission of hepatitis B:

• use condoms and water-based lube during sex, including oral sex
• avoid sharing injecting equipment, toothbrushes and razors and make sure body artists use sterile equipment for tattoos and piercings
• avoid sharing injecting equipment including needles, syringes, swabs, spoons, filters, water and tourniquets
• always use new injecting equipment
• always wash your hands before and after injecting
• avoid sharing personal items such as toothbrushes, razors and nail scissors / clippers
• make sure body artists use new and sterile equipment for tattooing, body piercing and other body art
• wear disposable gloves if you give someone first aid or are cleaning up blood or body fluids

Hepatitis B and pregnant women

Hepatitis B can be passed on to the baby around the time of birth. If a woman has hepatitis B, her baby will be given vaccination as soon as they are born—this is very effective. Some hospitals are now starting to use anti hepatitis B medicines (tablets) during pregnancy to reduce the chance even more of the baby getting hepatitis B, but this is not yet commonly done.

Hepatitis B & HIV

If you are HIV positive one of the consequences of getting hepatitis B infection is that it may require you to temporarily stop taking certain kinds of anti-HIV medications. Many HIV drugs are processed in the body through the liver, and cannot be tolerated during acute hepatitis illness. Studies have not reliably shown any link between hepatitis B and more rapid HIV disease progression though some have suggested such a link could exist.