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.
What Are Clinical Trials For Hepatitis B
Clinical trialsand other types of clinical studiesare part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.
Researchers are studying many aspects of hepatitis B, such as
- progression of hepatitis B and long-term outcomes
- new treatments for hepatitis B
- prevention of reactivated or worsening hepatitis B in people receiving cancer treatment
Screening And Prevention Of Hepatitis B
Hepatitis B testing in asymptomatic patients should be considered in:
- Men who have sex with men.
- Sex workers .
- Intravenous drug users.
- People from countries where hepatitis B is common.
- ‘Needlestick’ victims.
- Sexual partners of people who either have or who are at high risk of having hepatitis B.
- Workers with occupational risk – eg, healthcare workers.
If non-immune, consider hepatitis B vaccination. If found to be chronic carriers, consider referral for therapy. See also the separate Hepatitis B Vaccination and Prevention article.
- Vaccination may be universal or just for high-risk groups.
- The current recombinant vaccine is one of the safest available but, being grown in yeast cells, it should not be given to those allergic to yeast.
- Passive immunisation with specific hepatitis B immunoglobulin may be given to non-immune contacts after high-risk exposure.
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If I Have Hepatitis B And Feel Healthy Do I Need To Keep Going To My Doctor
Chronic hepatitis B is a silent disease because often no symptoms appear until your liver is severely damaged. Although many people with chronic hepatitis B have an inactive disease and will remain healthy, about one in four will have an active disease that may lead to cirrhosis, liver failure, and liver cancer.
Because hepatitis B has no symptoms until your liver is badly damaged, a blood test is the only way for your doctor to find out if your hepatitis B is active or inactive, and to offer treatment, if needed. To help your doctor monitor how your disease behaves over time, you will need lifelong repeat blood tests every six to 12 months. Some tests, such as HBV DNA may need to be done more frequently . No treatment is required while the virus is inactive, but you should continue to get regular blood tests from your doctor to monitor your liver disease.
Learn If A Specialist Is Covered By Your Insurance
If you have health insurance, its important to learn which specialists and services are covered by your plan. In most cases, its less expensive to visit a specialist whos in your network of coverage. If you visit an out-of-network specialist, you may have to pay more.
To learn if a specialist is covered by your insurance plan, contact your insurance provider. They can help you learn how much youll have to pay out of pocket to visit the specialist. They can also share the names of other specialists who are in your network.
Its also a good idea to contact the specialists office to ask if they accept your insurance. It never hurts to double-check.
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Chronic Hepatitis B Symptoms
Most patients with chronic hepatitis B are asymptomatic unless their disease progresses. Others might have nonspecific symptoms, such as fatigue.
Some patients experience worsening of the infection and develop signs and symptoms similar to acute hepatitis.
If patients with chronic hepatitis B progress to cirrhosis they will develop signs and symptoms of liver failure, including:
- Peripheral edema
- Hepatocellular carcinoma
What Do I Need To Know About Having Hepatitis B
If you have chronic hepatitis B, getting the right medical care can help you stay healthy. Taking good care of your liver is important. Talk with your doctor before you take any prescription medication, over-the-counter drugs, vitamins, or nutritional supplements to make sure they wont hurt your liver. You should also stay away from alcohol, because drinking can damage your liver.
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Antiviral Medication For Hepatitis B
Doctors may recommend antiviral medication for people with chronic hepatitis B, which occurs when the virus stays in your body for more than six months.
Antiviral medication prevents the virus from replicating, or creating copies of itself, and may prevent progressive liver damage. Currently available medications can treat hepatitis B with a low risk of serious side effects.
NYU Langone hepatologists and infectious disease specialists prescribe medication when they have determined that without treatment, the hepatitis B virus is very likely to damage the liver over time. People with chronic hepatitis B may need to take antiviral medication for the rest of their lives to prevent liver damage.
There are many different types of antiviral medications available, and your doctor recommends the right type for you based on your symptoms, your overall health, and the results of diagnostic tests. A doctor may take a wait-and-see approach with a person who has a healthy liver and whose blood tests indicate a low viral load, the number of copies of the hepatitis B virus in your bloodstream.
Someone with HIV infection or AIDS may have a weakened immune system and is therefore more likely to develop liver damage. The U.S. Centers for Disease Control and Prevention strongly recommends that people with HIV infection who are diagnosed with hepatitis B immediately begin treatment with antiviral medication.
How Is Hepatitis B Spread
You can become infected with hepatitis B through exposure to blood, semen and other bodily fluids of an infected person. You can get the infection by:
- Having unprotected sex.
- Sharing or using dirty needles for drug use, tattoos or piercing.
- Sharing everyday items that may contain body fluids, including razors, toothbrushes, jewelry for piercings and nail clippers.
- Being treated medically by someone who does not use sterile instruments.
- Being bitten by someone with the infection.
- Being born to a pregnant woman with the infection.
Hepatitis B is not spread by:
- Kissing on the cheek or lips.
- Coughing or sneezing.
- Hugging, shaking hands or holding hands.
- Eating food that someone with the infection has prepared.
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Who Are Hepatitis B Carriers
Hepatitis B carriers are people who have the hepatitis B virus in their blood, even though they dont feel sick. Between 6% and 10% of those people whove been infected with the virus will become carriers and can infect others without knowing it. There are over 250 million people in the world who are carriers of HBV, with about 10% to 15% of the total located in India. Children are at the highest risk of becoming carriers. About 9 in 10 babies infected at birth become HBV carriers, and about half of children who are infected between birth and age 5 carry the virus. A blood test can tell you if you are a hepatitis B carrier.
What Is The Difference Between Acute And Chronic Hbv
Acute HBV lasts for a short time. A person has chronic HBV when they have had the infection for 6 months or more. A person with chronic HBV might carry the infection indefinitely.
Acute HBV can develop into chronic HBV. A persons risk of developing chronic HBV is relative to the age at which they first developed the infection.
Newborns and young children with HBV have a higher risk of developing a chronic infection. According to the :
- around 9 in 10 infants with acute HBV will develop chronic HBV
- roughly 1 in 3 children who contract the infection before the age of 6 will develop chronic HBV
- almost all adults and children older than 6 with HBV will recover completely
- eating a nutritious diet
People with more severe symptoms may need to go to the hospital.
Doctors recommend having regular blood tests to check whether the infection has resolved or developed into chronic HBV.
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Emergency Hepatitis B Treatment
See your GP as soon as possible if you think you may have been exposed to the hepatitis B virus.
To help stop you becoming infected, they can give you:
- a dose of the hepatitis B vaccine you’ll also need 2 further doses over the next few months to give you long-term protection
- hepatitis B immunoglobulin a preparation of antibodies that work against the hepatitis B virus and can offer immediate but short-term protection until the vaccine starts to take effect
These are most effective if given within 48 hours after possible exposure to hepatitis B, but you can still have them up to a week after exposure.
Is Hepatitis B Curable
Theres no cure for hepatitis B. The good news is it usually goes away by itself in 4 to 8 weeks. More than 9 out of 10 adults who get hepatitis B totally recover.
However, about 1 in 20 people who get hepatitis B as adults become carriers, which means they have a chronic hepatitis B infection. Carriers are more likely to pass hepatitis B to other people. Most carriers are contagious meaning they can spread hepatitis B for the rest of their lives.
Hepatitis B infections that last a long time may lead to serious liver diseases like cirrhosis and liver cancer. About 1 in 5 people with chronic hepatitis B die from it. There are medicines that can help treat chronic hepatitis B infections.
Most babies who get hepatitis B during birth develop chronic infection, unless they get treated right away. But treatments are almost always effective if your baby gets them quickly. Thats why its important for pregnant people to get tested for hepatitis B.
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Prevent Infection After Contact With The Virus
If you think you have been in contact with the hepatitis B virus, see your doctor right away. Doctors typically recommend a dose of the hepatitis B vaccine to prevent infection. In some cases, doctors may also recommend a medicine called hepatitis B immune globulin to help prevent infection. You must get the vaccine dose and, if needed, HBIG shortly after coming into contact with the virus, preferably within 24 hours.
How To Find A Liver Specialist Who Really Knows Hepatitis B
If you have chronic hepatitis B or are newly-diagnosed, its important to see a liver specialist who has experience with hepatitis B.
Having a specialist with hepatitis B expertise on your team not only safeguards your health, it also lessens the stress of having a chronic liver disease. My specialist gave me all the possible scenarios, but most importantly, he gave me my life back, one hepatitis B patient recalled.
When first diagnosed, its often a primary health provider or for children a pediatrician who gets the test results and calls to break the news. Doctors may run additional blood tests and/or immediately refer you to a liver specialist. They may recommend a specialist who accepts your insurance or practices in the same healthcare system, but you may have to do some research to find the best specialist to treat your hepatitis B.
There are two types of specialists who treat liver diseases:
- A gastroenterologist is an internist who has trained in digestive disorders including the liver, but how much liver expertise a gastroenterologist has varies based on their training. Its important to find out if they specialize in liver diseases.
- A hepatologist is a physician who specializes in the liver. This doctor has the most expertise and should be up-to-date about new treatments and clinical trials. But not all hepatologists have treated hepatitis B. Many will have treated hepatitis C, but not hepatitis B, so you need to ask.
Tips for finding a specialist:
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How Is Hepatitis B Treated
Your healthcare provider will treat you based on what type of hepatitis B you have, acute or chronic.
Acute hepatitis B infections
If you develop an acute form of the condition, you probably wont need medical treatment. Instead, your doctor will likely suggest that you get plenty of rest, drink lots of fluids and maintain a healthy diet to support your body as it fights off the infection.
Chronic hepatitis B infections
If you have chronic hepatitis B, you might be a candidate for drug therapy. Usually, drug therapy is used only if you have active liver disease. There are seven drugs that are approved by the U.S. Food and Drug Administration to treat hepatitis B. Two are injectable forms of interferon, while the five other antivirals are tablets.
You will need to take these medications every day. They help by slowing the viruss ability to multiply in your system. This helps reduce swelling and liver damage. Youll need to be regularly monitored for early signs of liver damage and liver cancer. Your healthcare provider will want to see you once or twice a year.
How Could I Get Hepatitis B
You could get hepatitis B through contact with an infected persons blood, semen, or other body fluid. This contact could occur by
- being born to a mother with hepatitis B
- getting an accidental stick with a needle that was used on an infected person
- having unprotected sex with an infected person
- having contact with blood or open sores of an infected person
- sharing drug needles or other drug materials with an infected person
- being tattooed or pierced with unsterilized tools that were used on an infected person
- using an infected persons razor, toothbrush, or nail clippers
You could get hepatitis B from having unprotected sex with an infected person.
You cannot get hepatitis B from
- shaking hands or holding hands with an infected person
- being coughed or sneezed on by an infected person
- hugging an infected person
- light-colored stools
- yellowish eyes and skin, called jaundice
When symptoms occur, they can begin 2 to 5 months after coming into contact with the virus. See a doctor right away if you or a child in your care has symptoms of hepatitis B.
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What Happens With Hepatitis B
A majority of adults who contract hepatitis B have between mild symptoms and no symptoms at all, and then the virus resolves spontaneously however, about 5% of people are not able to eliminate the hepatitis B virus and develop chronic infection. If a chronically infected mother gives birth, 90% of the time her infant will be infected and develop chronic hepatitis B, usually for life. This may give rise to serious complications of liver disease later in life such as liver damage, liver failure, and liver cancer.
What Are The Symptoms Of Hepatitis B And C
In most patients, hepatitis B develops slowly over the course of several decades, and thus most patients have no symptoms. People who have advanced liver disease such as cirrhosis of the liver may experience complications and symptoms that reflect liver failure. Other symptoms include:
- A buildup of fluid within the abdominal cavity
- Confusion and tremors , which are complications due to the inability of the liver to filter out toxins that are normally cleaned out by a healthy liver
- Vomiting of blood, or blood within the stool . This is a complication in which enlarged veins within the esophagus or stomach bleed as a consequence of increased pressure around the diseased liver.
Most patients with chronic hepatitis C infection report no symptoms. But some patients may have very nonspecific symptoms related to fatigue and discomfort on the right side of the abdomen. Often, symptoms that lead to a diagnosis of hepatitis C are noticeable only at the end stage of liver disease, when the patient has developed liver cirrhosis and liver failure.
Because hepatitis B and C typically have no specific symptoms, many people who have the viruses dont even know it.
How Do Doctors Treat Hepatitis B
Doctors typically dont treat hepatitis B unless it becomes chronic. Doctors may treat chronic hepatitis B with antiviral medicines that attack the virus.
Not everyone with chronic hepatitis B needs treatment. If blood tests show that hepatitis B could be damaging a persons liver, a doctor may prescribe antiviral medicines to lower the chances of liver damage and complications.
Medicines that you take by mouth include
A medicine that doctors can give as a shot is peginterferon alfa-2a .
The length of treatment varies. Hepatitis B medicines may cause side effects. Talk with your doctor about the side effects of treatment. Tell your doctor before taking any other prescription or over-the-counter medicines.