What is hepatitis B?

Hepatitis B (often called hep B, HBV, dirty B or heppie B) is part of the group of hepatitis viruses that causes inflammation of the liver. Not to be confused with hepatitis A, which is spread through poor sanitation, or hepatitis C, which is mostly transmitted by sharing dirty needles, hepatitis B is an STI that's passed on during any kind of unprotected sex, as well as from contaminated needles used in drug abuse, tattooing, acupuncture or body piercing.

It's highly contagious and can survive in excess of a week in dried blood, which makes sharing things like towels, razor blades, toothbrushes and nail clippers with an infected person very risky. But before paranoia sets in, you can't catch it from toilet seats, coughing, sneezing, or touching an infected person.

Although hepatitis has been around for centuries, doctors had no idea what caused it until the 1940s, when they came to suspect that a virus carried in human blood was responsible. However, it took years before its various forms were identified. Now, while new reported cases in the UK are rare, it affects two billion people worldwide, making it the 10^th leading cause of death. In Asia and Africa most people pick up the virus around the time of birth or during childhood, but many adults pick it up while on holiday. Casual sex, experimenting with drugs and accidents needing medical treatment are mostly to blame.

What are the hepatitis B symptoms?

The scary thing is that most people will show no signs of being infected. Called asymptomatic carriers, they're still infectious and can unknowingly pass on the disease to others. However, for those who do have symptoms, there are two stages of hepatitis B infection: acute and chronic.

Acute (or short-term) symptoms can take up to six months to appear and can easily be mistaken for a bad case of the flu.  Those infected can experience nausea, vomiting, aching muscles and joints, weight loss, tiredness, and loss of appetite. Symptoms can last anything up to two months but most people make a full recovery and never get it again. Once you recover, your body will develop antibodies that protect you from the virus for life.

For those who can't fight off the infection (babies and young children, people with a weakened immune system because of HIV) the disease moves onto the chronic stage. Patients in this stage are at higher risk of liver failure, liver disease and cancer of the liver, and yet can be blissfully unaware of what's happening to their bodies as the symptoms can take years to develop.

What does hepatitis B look like?

From no symptoms at all to a long bout of the flu, the signs aren't obvious.  

How is hepatitis B treated?

If you know you've slept with a carrier, or have a strong suspicion you have, go to your nearest genitourinary medicine (GUM) clinic or make an appointment to see your doctor (GP). A blood test will determine whether you have been infected and if the virus is still in your body. For most people, bed rest, no booze and a change in diet is all that's required for a full recovery. However, it's important that the infection is monitored to check whether chronic disease develops. If it progresses, specific drug treatment will be prescribed to reduce the risk of permanent liver damage (cirrhosis) and liver cancer. The patient will also be referred to a liver specialist. When there's severe damage to the liver, a liver transplant is recommended - although this is rare.

What if I ignore it?

It may be hard to acknowledge something that's not visible or causing you any grief, but ignoring it could mean becoming a long-term carrier of hepatitis B, which not only poses a risk of passing it on but also the prospect of permanently damaging your liver. An infected mother can also pass the virus on to her baby during childbirth; this is the most common way that hepatitis B is spread worldwide.

How do I protect myself from contracting hepatitis B?

You can reduce your risk by avoiding certain situations: risky one-night stands; unprotected sex; dubious tattoo parlours or acupuncturists; and sharing syringes, razors, toothbrushes or nail clippers with infected people. Also, using a condom offers some protection.

If you are in a high-risk group for catching hepatitis B (drug addict, sex worker, your occupation involves the risk of exposure to the virus, e.g. paramedic, you're travelling to countries where the virus is widespread) you can be immunised against it. Ask your GP for advice.

How soon can I have sex again?

Regardless of how mild or non-existent your symptoms, it's important to wait until the GP has given you the all clear to prevent spreading the disease.

Updated: 01/11/2010