How To Get Hepatitis B

How Can I Avoid Getting Hepatitis B

There is a safe and effective vaccine that can protect you from getting hepatitis B. The vaccine is usually given in three doses over a six month period. The vaccine will give you long-lasting protection. A combined vaccine for hepatitis A and hepatitis B is also available.

Other ways to protect yourself or your loved ones include:

• Adopt safe sex practices.
• Avoid sharing personal hygiene items
• If you have been exposed to the hepatitis B virus , an injection of hepatitis B immune globulin may help protect you.
• If you are pregnant, make sure you are screened for hepatitis B. If the test result shows that you have the virus, make sure your baby receives the free hepatitis B vaccine. If you have hepatitis B, breastfeeding is safe if the baby has received both protective antibody called immune globulin, and the first dose of hepatitis B vaccine within the first 12 hours of life. Talk to your doctor about having your newborn immunized .
• If you decide to have a tattoo, piercing, manicure or pedicure, ensure that the facility uses single-use needles and inks and/or follows proper sterilization procedures.

Outlook For Hepatitis B

The vast majority of people infected with hepatitis B in adulthood are able to fight off the virus and fully recover within 1 to 3 months.

Most will then be immune to the infection for life.

Babies and children with hepatitis B are more likely to develop a chronic infection.

Chronic hepatitis B affects around:

• 90% of babies with hepatitis B
• 20% of older children with hepatitis B
• 5% of adults with hepatitis B

Although treatment can help, there’s a risk that people with chronic hepatitis B could eventually develop life-threatening problems, such as scarring of the liver or liver cancer.

Page last reviewed: 30 January 2019 Next review due: 30 January 2022

What Is Chronic Hepatitis B

Doctors refer to hepatitis B infections as either acute or chronic:

• An acute HBV infection is a short-term illness that clears within 6 months of when a person is exposed to the virus.
• A person who still has HBV after 6 months is said to have a chronic hepatitis B infection. This is a long-term illness, meaning the virus stays in the body and causes lifelong illness. An estimated 850,000 to more than 2 million people in the U.S. have chronic HBV.

The younger someone is when infected, the greater the chances for chronic hepatitis B.

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Chronic Hepatitis B Complications

Chronic hepatitis B can lead to

• cirrhosis, a condition in which scar tissue replaces healthy liver tissue and prevents your liver from working normally. Scar tissue also partly blocks the flow of blood through the liver. As cirrhosis gets worse, the liver begins to fail.
• liver failure, in which your liver is badly damaged and stops working. Liver failure is also called end-stage liver disease. People with liver failure may require a liver transplant.
• liver cancer. Your doctor may suggest blood tests and an ultrasound or another type of imaging test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.

Reduce Your Chance Of Infection

You can reduce your chance of hepatitis B infection by

• not sharing drug needles or other drug materials
• wearing gloves if you have to touch another persons blood or open sores
• making sure your tattoo artist or body piercer uses sterile tools
• not sharing personal items, such as toothbrushes, razors, or nail clippers
• using a latex or polyurethane condom during sex

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What Are The Risk Factors For Getting Hepatitis B

Due to the way that hepatitis B spreads, people most at risk for getting infected include:

• Children whose mothers have been infected with hepatitis B.
• Children who have been adopted from countries with high rates of hepatitis B infection.
• People who have unprotected sex and/or have been diagnosed with a sexually transmitted infection.
• People who live with or work in an institutional setting, such as prisons or group homes.
• Healthcare providers and first responders.
• People who share needles or syringes.
• People who live in close quarters with a person with chronic hepatitis B infection.
• People who are on dialysis.

Persons With Inadequate Immunization Records

Evidence of long term protection against HB has only been demonstrated in individuals who have been vaccinated according to a recommended immunization schedule. Independent of their anti-HBs titres, children and adults lacking adequate documentation of immunization should be considered susceptible and started on an immunization schedule appropriate for their age and risk factors. Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional information.

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Whats The Prognosis For Hepatitis B

Your doctor will know youâve recovered when you no longer have symptoms and blood tests show:

• Your liver is working normally.
• You have hepatitis B surface antibody.

But some people don’t get rid of the infection. If you have it for more than 6 months, youâre whatâs called a carrier, even if you donât have symptoms. This means you can give the disease to someone else through:

• Unprotected sex
• Contact with your blood or an open sore
• Sharing needles or syringes

Doctors donât know why, but the disease does go away in a small number of carriers. For others, it becomes whatâs known as chronic. That means you have an ongoing liver infection. It can lead to cirrhosis, or hardening of the organ. It scars over and stops working. Some people also get liver cancer.

If youâre a carrier or are infected with hepatitis B, donât donate blood, plasma, body organs, tissue, or sperm. Tell anyone you could infect — whether itâs a sex partner, your doctor, or your dentist — that you have it.

Show Sources

CDC: âHepatitis B Questions and Answers for Health Professionals,â âHepatitis B Questions and Answers for the Public.â

Mayo Clinic: âHepatitis B.â

UpToDate: âHepatitis B virus: Screening and diagnosis.â

CDC.

HealthyPeople.gov: âHepatitis B in Pregnant Women: Screening.â

Annals of Internal Medicine: âScreening for Hepatitis B Virus Infection in Nonpregnant Adolescents and Adults: U.S. Preventive Services Task Force Recommendation Statement.â

Eating Diet And Nutrition For Hepatitis B

If you have hepatitis B, you should eat a balanced, healthy diet. Obesity can increase the chance of nonalcoholic fatty liver disease , and NAFLD can increase liver damage in people who have hepatitis B. Talk with your doctor about healthy eating and maintaining a healthy weight.

You should also avoid alcohol because it can cause more liver damage.

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Treatments For Hepatitis B

Treatment for hepatitis B depends on how long you have been infected for.

If you have been exposed to the virus in the past few days, emergency treatment can help stop you becoming infected.

If you have only had the infection for a few weeks or months , you may only need treatment to relieve your symptoms while your body fights off the infection.

If you have had the infection for more than 6 months , you may be offered treatment with medicines that can keep the virus under control and reduce the risk of liver damage.

Chronic hepatitis B often requires long-term or lifelong treatment and regular monitoring to check for any further liver problems.

Treatment Options For Hepatitis B

Acute hepatitis B usually doesnt require treatment. Most people will overcome an acute infection on their own. However, rest and hydration will help you recover.

Antiviral medications are used to treat chronic hepatitis B. These help you fight the virus. They may also reduce the risk of future liver complications.

You may need a liver transplant if hepatitis B has severely damaged your liver. A liver transplant means a surgeon will remove your liver and replace it with a donor liver. Most donor livers come from deceased donors.

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Which Adults Should Be Vaccinated Against Hepatitis B

According to CDC recommendations, adults in the following groups are recommended to receive hepatitis B vaccine:

General

• All people age 18 years and younger.
• Anyone 19 years and older who wants to be protected from hepatitis B.

People at risk for infection by sexual exposure

• Sex partners of people who are hepatitis B surface antigen -positive.
• Sexually active people who are not in long-term, mutually monogamous relationships.
• People seeking evaluation or treatment for a sexually transmitted disease.
• Men who have sex with men.

People at risk for infection by percutaneous or permucosal exposure to blood or body fluids

• Current or recent illegal injection drug users.
• Household contacts of people who are HBsAg-positive.
• Residents and staff of facilities for developmentally challenged people.
• Healthcare and public safety workers with reasonably anticipated risk for exposure to blood or blood-contaminated body fluids.
• People with end-stage renal disease, including predialysis, hemo-, peritoneal- and home-dialysis patients.

Others

• International travelers to regions with intermediate or high levels of endemic HBV infection.
• People with chronic liver disease.
• People with HIV infection.
• People with diabetes who are age 19 through 59 years. For those age 60 and older, clinicians should make a determination of need for
• vaccination based on their patients’ situation.

In a future issue, we will review the various hepatitis B serologic tests, who needs testing, and when they need it .

For Adults And Children

This vaccine schedule involves three doses within 2 months, followed by a booster dose at 1 year.

The initial accelerated doses provide immediate protection from HBV, and the booster dose helps provide long-term protection.

Below is the accelerated vaccination schedule approved for both adults and children:

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When To Get Medical Advice

Hepatitis B can be serious, so you should get medical advice if:

• you think you may have been exposed to the hepatitis B virus emergency treatment can help prevent infection if given within a few days of exposure
• you have symptoms associated with hepatitis B
• you’re at a high risk of hepatitis B high-risk groups include people born in a country where the infection is common, babies born to mothers infected with hepatitis B, and people who have ever injected drugs

You can go to your local GP surgery, drug service, genitourinary medicine clinic or sexual health clinic for help and advice.

A blood test can be carried out to check if you have hepatitis B or have had it in the past.

The hepatitis B vaccine may also be recommended to reduce your risk of infection.

How Many People Have Hepatitis B

In the United States, an estimated 862,000 people were chronically infected with HBV in 2016. New cases of HBV infection in the United States had been decreasing until 2012. Since that time, reported cases of acute hepatitis B have been fluctuating around 3,000 cases per year. In 2018, 3,322 cases of acute hepatitis B were reported however, because of low case detection and reporting, the Centers for Disease Control and Prevention estimates that there were 21,600 acute hepatitis B infections. New HBV infections are likely linked to the ongoing opioid crisis in the United States.

Globally, HBV is the most common blood-borne infection with an estimated 257 million people infected according to the World Health Organization .

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How Do You Know If You Have Hepatitis B

Signs and symptoms can vary, in particular by the age of the individual. Many individuals may not show symptoms . When symptoms develop, they include fever, joint pain, abdominal pain, fatigue, lack of appetite, nausea, vomiting, dark urine, clay-coloured bowel movements, or jaundice.

Most infections are asymptomatic or mild. Occasionally, people with serious cases of hepatitis B require hospitalization. A very small proportion of these patients develop a critical form of the disease called “fulminant” hepatitis B. This condition results from a sudden breakdown of liver function.

Can Hepatitis B Be Treated

If you know you have been exposed to the hepatitis B virus in the previous seven days or less, you can receive an injection of hepatitis B immune globulin that may prevent you from developing the disease. Besides this, there is no treatment for acute hepatitis B.

If you have chronic hepatitis B, two types of treatment exist interferon which is a medication administered by a needle, and antiviral medicines that are taken by mouth. Current approved hepatitis B oral medications include lamivudine, adefovir, telbivudine, tenofovir, and entecavir. These treatments do not provide a cure, but they offer control of the virus so that further damage to your liver can be prevented. When and how to treat your hepatitis B is a decision between you and your doctor. Availability of the medications listed above may vary from province to province based on provincial government drug plans and individual insurance plans.

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Questions To Ask Your Doctor

• How did I get hepatitis B?
• What treatment is best for me?
• Can I be cured of hepatitis B?
• Are there any medicines I should take?
• What can I do to protect my friends and family from hepatitis B?
• How long will my treatment last?
• Is it possible for hepatitis B to come back?
• Should I get the hepatitis B vaccine?
• What are the side effects of antiviral medicines?
• Will my liver ever be normal again?

What Should You Know About Hepatitis B Before You Travel

Hepatitis B is quite common in China and other Asian countries, where as many as 1 in 12 people have the virus, though many dont know it. Before traveling to those places, you should make sure youve been vaccinated against the virus.

In addition to getting the vaccine, you can take these additional precautions to reduce your risk of contracting the virus:

• Refrain from taking illegal drugs.
• Always use latex or polyurethane condoms during sex.
• Make sure new, sterile needles are used during all piercings, tattoos and acupuncture sessions.
• Avoid direct contact with blood and bodily fluids.
• Know the HBV status of all your sexual partners.
• Ask your doctor about possible vaccination before you travel to a place where hepatitis B is common.

A note from Cleveland Clinic

Hepatitis B is a liver disease that can cause serious damage to your health. One reason that is dangerous is that it can easily go undetected for years while damaging your liver. Talk with your healthcare provider about being tested for hepatitis B if you have any reason to believe that you were not vaccinated or if you have engaged in risky behavior. If you do test positive, follow the directions from your healthcare provider so that you can live a longer, healthier and happier life.

Last reviewed by a Cleveland Clinic medical professional on 07/09/2020.

References

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Treatment For Suspected Exposure

Anyone who has had potential exposure to HBV can undergo a postexposure prophylaxis protocol.

This consists of HBV vaccination and hepatitis B immunoglobin . Healthcare workers give the prophylaxis after the exposure and before an acute infection develops.

This protocol will not cure an infection that has already developed. However, it decreases the rate of acute infection.

What Problems Can Hepatitis B Cause

Hepatitis B is a serious infection. It can lead to cirrhosis of the liver, liver failure, or liver cancer, which can cause severe illness and even death.

If a pregnant woman has the hepatitis B virus, her baby has a very high chance of having it unless the baby gets a special immune injection and the first dose of hepatitis B vaccine at birth.

Sometimes, HBV doesn’t cause symptoms until a person has had the infection for a while. At that stage, the person already might have more serious problems, such as liver damage.

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Can Hepatitis B Be Prevented

The hepatitis B vaccine is one of the best ways to control the disease. It is safe, effective and widely available. More than one billion doses of the vaccine have been administered globally since 1982. The World Health Organization says the vaccine is 98-100% effective in guarding against the virus. Newborns should be vaccinated.

The disease has also been more widely prevented thanks to:

• Widespread global adoption of safe blood-handling practices. WHO says 97% of the blood donated around the world is now screened for HBV and other diseases.
• Safer blood injection practices, using clean needles.
• Safe-sex practices.

You can help prevent hepatitis B infections by:

• Practicing safe sex .
• Never sharing personal care items like toothbrushes or razors.
• Getting tattoos or piercings only at shops that employ safe hygiene practices.
• Not sharing needles to use drugs.
• Asking your healthcare provider for blood tests to determine if you have HBV or if you are immune.

The National Vaccine Injury Compensation Program

The National Vaccine Injury Compensation Program is a federal program that was created to compensate people who may have been injured by certain vaccines. Claims regarding alleged injury or death due to vaccination have a time limit for filing, which may be as short as two years. Visit the VICP website at or call to learn about the program and about filing a claim.

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Vaccination And Other Prevention Measures

Vaccination is a safe and effective way of preventing the spread of hepatitis B. Since 1985, the hepatitis B vaccine has been part of the national immunisation schedule. In 1988, New Zealand was one of the first countries to introduce universal infant hepatitis B immunisation.The vaccine is given to babies at age six weeks, three months, and five months. Babies born to mothers with hepatitis B receive an extra dose of the vaccine at birth as well as a dose of hepatitis B-specific immune globulin.In children and adolescents who did not receive the hepatitis B vaccine in the first year of life, the full three-dose course is recommended.Hepatitis B immunisation is recommended and publicly funded for all infants and children up to their 18th birthday, household and sexual contacts of people with acute or chronic hepatitis B, and certain other high-risk populations. Measures that can help prevent the spread of the hepatitis B virus include:

• Teaching children not to touch the blood or wounds of others
• Covering cuts, scratches, and grazes
• Not sharing personal items such as razors and toothbrushes
• Never sharing needles or syringes if you use intravenous drugs
• Practising safe sex, including the use of condoms
• Seek assurance that body piercing and tattooing needles and equipment are sterile.