Hepatitis B

What is hepatitis B?

Hepatitis B is a liver disease caused by a hepatitis B virus infection. This virus particularly attacks the liver, which is the largest organ in the human body. The presence of this virus kills liver cells, which means that your liver may not be able to function properly.

The human body’s defence mechanisms against the virus vary between people, which explains the variety of forms, including acute hepatitis, chronic hepatitis, and asymptomatic carriers.

The liver is a vital organ. It has many functions – the main ones are:

• Storing and distributing nutrients from the digestion process

• Detoxifying the body by breaking down toxins naturally produced by the body, and external toxins like alcohol

• Producing most blood proteins

• Producing bile, an essential fluid in the fat digestion process

In the UK, there are an estimated 180,000 people with chronic hepatitis B. It is estimated that 240 million people are living with the disease worldwide. It is particularly prevalent – as much as 10% – among adults in Sub-Saharan Africa and Southeast Asia.

There’s no known cure for the disease. Antiviral therapy can be used to keep the infection in check. In terms of prevention, the hepatitis B vaccine can be highly effective.

What are the symptoms of hepatitis B?

Acute hepatitis B is usually asymptomatic. If you do develop symptoms, you might feel fatigued, and your skin and eyes may turn a yellow colour – a condition known as jaundice.

Other symptoms can include:

• A loss of appetite

• Pain in the liver and the upper right side of your tummy

• Fever

• General aches and pains

Acute hepatitis usually lasts about 2 months. In adulthood, 90 to 95% of people infected with the virus fully recover within 6 months, but just 5 to 10% of infected children will recover.

The main risk of acute hepatitis is that it can develop into a rare but very serious condition, known as fulminant hepatitis. An urgent liver transplant may be needed in these cases. Once the acute infection passes, chronic hepatitis occurs when the virus lingers in the body.

Chronic hepatitis tends to progress ‘silently’ for several years before complications caused by progressive liver damage like cirrhosis or cancer emerge. Even completely asymptomatic chronic carriers can still pass on the virus, so it’s important that people at an increased risk get tested regularly.

What are the possible outcomes?

Once hepatitis B virus has entered the body, only 5% of adults will develop the chronic form. In contrast, this figure can be up to 95% in children and babies with the infection. Chronic hepatitis B is a slow, silent killer of liver tissue, and can lead to cirrhosis or cancer.

How is hepatitis B spread?

The virus can spread in a number of ways:

• Contact with blood or other bodily fluids, for example:

  • Tattoos or body piercing procedures

  • Sharing toothbrushes or razors

  • Sharing needles in drug users

• Sexual transmission

• Transferred from an infected mother to her unborn baby

Who is at risk of hepatitis B?

Some people have a greater risk of catching the virus. Hepatitis B screening is particularly recommended for:

• People travelling from areas where infection is common

• Close household contact carriers of HBV

• Intravenous or intranasal drug users and their close contacts

• People who have other STIs (HIV, HCV) or who change partners regularly

Hepatitis B serology

Hepatitis B serological tests can detect the virus in people who may have been exposed. The infection can be diagnosed using a blood test. Screening is recommended for:

• People who aren’t vaccinated and are returning from an area where infection is common

• People who have had unprotected sex

• People who have had close contacts with HBV carriers

• Intravenous or intranasal drug users

• People who have had other STIs (HIV, HCV)

How is the virus treated?

If you’re diagnosed with hepatitis B, you’ll need to see specialists in liver disease and infectious diseases for your initial treatment and follow-up.

• Acute hepatitis B – You will be advised to rest. Avoid consuming anything that might harm the liver (alcohol and some medicines that are potentially toxic for the liver). You’ll be monitored closely with regular blood tests to assess your liver function. For the majority of patients, the virus will be cleared from the body within 6 months and you will be immune.  

• Chronic hepatitis B – In some patients, the virus is not cleared and you may be diagnosed with chronic hepatitis. There’s no cure for hepatitis B, unlike hepatitis C. You may be offered antiviral medications but this depends from person to person. You will be under the care of a specialist, known as a hepatologist, and you will have regular follow up and blood tests.

What can you do to prevent hepatitis B?

Vaccination can help prevent hepatitis B along with these precautions to reduce the spread of the disease:

• Use condoms when you have sex

• For intravenous drug users, use single-use injection equipment

• Use single-use or sterile equipment when getting a tattoo or piercing

• Screen blood donations

Hepatitis B vaccination

In the UK, all infants will be offered a vaccination against Hepatitis B in the routine schedule of vaccinations. It is given to infants at 8, 12 and 16 weeks old.

It can also be given to older children and adults in certain circumstances, such as when travelling, drug users or where your job puts you at a higher risk of contact with hepatitis B (such as in healthcare or the prison system). 

When should you seek medical advice?

If you’re unvaccinated and planning to travel to a part of the world with a high prevalence of the disease, we recommend that you get medical advice on how to prevent infection. We also recommend speaking to a doctor if you feel that you are in a ‘risk category’ for hepatitis B, such as those described above. 

You should see a doctor as soon as possible if you notice these hepatitis symptoms:

• Fever, general aches and pains, fatigue

• Jaundice (yellowing of your skin and whites of your eyes)

• Very dark pee along with discoloured poo

• Pain in the upper right side of your tummy

Get urgent medical advice if you have any of the following symptoms:

• Persistent severe jaundice

• Abnormal bleeding

• Sleeping problems

• Feeling confused or drowsy

How can Livi help?

Our doctors can advise you on the next steps dependent on your symptoms. We can advise on blood tests and refer you to a hepatologist if necessary. We can also advise you on where to get vaccinated against hepatitis B.