Sexually Transmitted Infections
What Are They?
Hepatitis B Virus
What is hepatitis B?
The word hepatitis means "inflammation of the liver". Hepatitis B is a sexually transmitted virus that can cause scarring of the liver, liver failure, and liver diseases such as cirrhosis and liver cancer. Worldwide, hepatitis B is very common.
Hepatitis B is incurable, but a vaccine exists and most infections will clear up on their own. Most people will have no symptoms of an infection. For these reasons, many people who are infected with hepatitis B may never know it and still transmit it.
Hepatitis B infection can either be a short-term "acute" infection or a long-term "chronic" infection.
When a person is first infected with the hepatitis B virus, they are said to have an "acute" infection.
During this time, a person may or may not have symptoms. For those that do, they may have few or very mild "flu-like" symptoms, or in rare cases they may have very severe symptoms requiring medical attention such as jaundice (yellow skin and eyes), abdominal pain, cutaneous eruption, or joint pain.
During an acute infection, which can last up to six months, a person can transmit the virus to others. About 90 percent of adults will recover from the acute stage within a few months of infection, as their bodies develop immunity to the virus and fight off the infection.1 These people will not develop "chronic" hepatitis. Their symptoms disappear (if they have any), they will no longer be able to transmit the virus to others and they typically have no long-term effects of the infection.
For others, their bodies will not be able to fight off the virus, and will develop "chronic" hepatitis, which is a long-term infection of the liver. These persons are called "chronic carriers" and can transmit infection all their lives.
A person has "chronic" hepatitis B if the infection persists for more than 6 months. About 350 million people worldwide have long-term hepatitis B infection.2 Chronic hepatitis B may last for life; however an infected person may have no symptoms. Whether they experience symptoms or not, this person can actively transmit the disease to others.
Infants can contract the hepatitis B virus during birth, and will almost always develop chronic hepatitis.
Those with a chronic hepatitis infection may develop serious liver damage over time. Chronic hepatitis B infected are at higher risk of liver failure and liver diseases such as cirrhosis and liver cancer. In some cases, complications of liver damage causes death.
How do you get hepatitis B?
Hepatitis B is a sexually transmitted infection and can be spread through anal, vaginal or oral sex with an infected partner.
It may be spread from an infected mother to her child during birth.
It can also be passed along through blood-to-blood contact such as sharing needles for drug use, or by sharing personal items like razors or toothbrushes that have come into contact with infected blood.
Preventing hepatitis B infection
If you are at higher risk of contracting the virus, ask your health care professional about getting the hepatitis B Vaccine.
Practice abstinence or safer sex using condoms.
Never share personal items such as razors or toothbrushes with an infected person.
Avoid activities that could cause you to be exposed to infected blood or semen.
Never share needles for injection drugs.
Symptoms
In many acute and chronic infections, the infected person will have no symptoms. These cases may go completely unnoticed, or unnoticed for a long period of time after infection.
Symptoms of acute hepatitis are often mild and may be mistaken for the flu. These include: tiredness, aching joints, pain in the stomach area, loss of appetite, nausea and a general feeling of sickness. In some cases, hepatitis B may also cause Jaundice, which is a sign of liver problems.
At first, many people with chronic hepatitis B infections will have no symptoms; however, a chronic infection can cause serious liver scarring, and sometimes-fatal liver diseases including cirrhosis and liver cancer. People who are infected with the virus but do not show symptoms can still transmit the infection to others. Drinking alcohol can speed the destruction of the liver in people with hepatitis.
For those who do show symptoms of the infection, these symptoms will usually appear within 45 to 180 days of infection.
Testing
Hepatitis B infection can be tested for with a blood test.
Treatment
There are some treatments available for chronic hepatitis B infections that help control the virus from spreading. However, these medications are not recommended for everyone.
Impact if not treated
Hepatitis B can cause permanent damage to the liver, including cirrhosis of the liver, liver cancer or liver failure.
Pregnant women who carry the virus can pass it to their infants during birth; however, treatment exists that can help prevent transmission from an infected mother. In Canada, pregnant women are routinely tested for hepatitis B infection before giving birth.
People with weakened immune systems because of HIV infection are at a much higher risk of developing a chronic hepatitis infection.
About the vaccine
The hepatitis B vaccine works by "tricking" your body into thinking it has hepatitis B. The vaccine is not a virus and it will not hurt you, but to your body, the vaccine "looks" exactly like the hepatitis B virus. Because your body thinks a virus is invading it, it will build up defences to try to fight it off. To do this, your body produces special cells, built for the specific purpose of fighting off hepatitis B. Your body will continue to produce these defences long after the vaccine is gone. This way, if you ever get the real hepatitis B virus, your body will have defences ready, and will be able to fight off the virus before it establishes itself in your body.
In Canada, all provinces and territories in Canada currently have a universal childhood hepatitis B immunization program in place.
The vaccine may also be recommended for:
- people who are at high risk, such as people who have many sexual partners or men who have sex with men
- people who share needles
- people who work in environments where they may come into contact with contaminated blood or body fluids, and people who require certain transfusions or blood procedures
- a person whose partner has hepatitis B
- people who have certain liver diseases.
What to tell your partner
For an existing partner: If you have an existing partner or partners and are diagnosed with an acute or chronic hepatitis infection, be honest and ask them to go for testing. Remember, the vast majority of adults who are infected with HBV will not develop a chronic infection. Your partner(s) may have already cleared an HBV infection with mild or no symptoms. Or, they may never have been infected.
However, there is also a chance that they will develop a severe acute infection or a chronic infection. So, be honest, tell your partner, explain the risks and consider offering to accompany them for testing.
If testing determines that your partner has never been infected with hepatitis B, he or she will not have immunity to the hepatitis B virus. In this case, you may want to ask your partner to be vaccinated by the health care professional.
For new partners: Chronic hepatitis B virus can be spread, is incurable and can be very serious. For this reason, if you have an infection and are starting a relationship with a new partner, you have a responsibility to inform them. Explain the risks and that a vaccine exists, and that he or she may want to be vaccinated. Talk to your health care provider about the vaccine, safer sex methods including condoms, and ways to reduce the risk of transmission.
When can I have sex again?
You can have sex after an acute case clears up and you are no longer infectious. Remember, you may still be infectious even if you have no symptoms. You will need to see a health care professional for testing to be sure the infection is gone. As always, you should practice safer sex to reduce the risk of transmission of hepatitis B or other STIs.
If you have chronic hepatitis B infection, consult a health care professional before having sex again. If you are already in a sexual relationship, your partner should be tested. They may have the virus, or they may already be immune to the virus from a previous case that has cleared up. If they have not contracted the virus, consult a health care professional about safer sex and possibly having your partner vaccinated against hepatitis B. You should use condoms to try to prevent the risk of transmission.
Last Modified: May 22, 2007
