This can occur in the following ways:

• Unprotected sex.
• Sharing injecting drug equipment (includes needles, syringes, spoons, filters, water and tourniquets).
• Piercing or tattooing that is done with non sterile equipment (check out our getting a safe tattoo video above)
• Needle stick injuries (getting pricked by someone else’s used fit).
• An infected person’s blood coming into contact with an open cut, sore or, more rarely, the eyes of an
• uninfected person.
• Sharing personal hygiene items that may have tiny, even invisible, traces of blood on them such as razor blades or toothbrushes.

You are especially at risk if there is any blood involved during sex (for example, during rough or anal sex or if you already have any cuts or sores in your vagina or on your penis). It is also likely that the presence of another sexually transmitted infection will increase the risk of transmission of Hep B. Using condoms will help prevent the spread of Hepatitis B but the best prevention is for people to be vaccinated.

Mother to baby

A mother with chronic Hep B can give the virus to her baby during pregnancy or during birth; however there is treatment to help prevent this.

In Australia, it’s recommended all newborns are vaccinated in their first week (with the first of three injections) although babies born to mothers with chronic Hep B infection receive an additional injection of Immunoglobulin. Immunoglobulin contains antibodies that prevent Hep B infection.

Signs and symptoms

The symptoms of acute Hep B and the severity of these symptoms vary from person to person, depending on the age at which you are infected. Babies and children generally have fewer symptoms and so health care workers may not even detect it.

If exposed to Hep B as an adult you can become quite sick with:

• Nausea and / or Fever
• Loss of appetite
• Pain in the liver (under the bottom section of your right ribcage)
• Pain in the joints
• Dark coloured urine
• Yellowing of the skin and the whites of the eyes (jaundice)

Usually these symptoms go away after a few weeks but sometimes adults with acute Hep B get so sick they need to be monitored in hospital. And although people generally feel fine after recovering from this acute episode they may still have the virus in their blood and can therefore still give Hep B to their sexual partner(s) or anyone else at risk of blood to blood contact.

Chronic Hep B can lead to cirrhosis (scarring) of the liver.

What are the long term health problems of Hep B?

Generally, if you’re older than 15 when you first get Hep B, you will get over the infection in a number of months.

(About 95% of adults clear Hep B themselves.) If the infection doesn’t clear by itself however, and is still in

your body 6 months later, then you are now said to have chronic or long term Hep B. This means you will need regular monitoring by a doctor and occasional review from a liver specialist to make sure you’re keeping as healthy as possible.

This is because chronic Hep B (infection that has lasted more than 6 months) can lead to cirrhosis (scarring) of the liver and increased risk of developing liver cancer later in life. You need to be realistic about life style choices such as diet, alcohol and drug use but understand it really is important to try and minimize any extra damage to your liver.

So if you do have chronic Hep B you’ll stay healthy for longer if you minimize your drug and alcohol intake and be kind to your liver by eating as healthy a diet as you can, no matter what your living situation.

How do you prevent getting Hep B?

• Get vaccinated against Hep B (and make sure you get all three shots, one or two may not give you long term protection).
• Use condoms and dams for vaginal or anal sex.
• Avoid oral sex if there is any chance of blood to blood contact (eg. if you or your partner have Herpes, ulcers or bleeding gums).
• If you inject drugs, encourage anyone you use with to get vaccinated.
• Encourage all sexual partners to get vaccinated.
• Don’t share injecting equipment (this includes needles, syringes, spoons, filters, tourniquets, swabs and water. If you’re sharing a mix, ensure that whoever prepares it has washed their hands thoroughly with soapy water and is using only new equipment from the NSP).

IMPORTANT NOTE:

It is recommended that anyone travelling overseas be vaccinated, especially if traveling to a country where there are high rates of Hep B.

How do you find out if you have Hep B?

Hep B can only be diagnosed with a blood test. It is important to remember that it can take as long as 6 months after initial exposure to Hep B before it shows up in your blood test (as antibodies). This six months period is referred to as the “window period”. To be extra sure you have not been infected with Hep B, it’s important to get another follow up test six months later, when the window period has finished.

If you do test positive for Hep B, specific blood tests can tell whether you have chronic (any longer than 6 months) or acute (less than 6 months) Hep B infection. This kind of information will help the doctor decide what the best treatment is for you.

Blood tests can also tell you whether or not you have immunity from Hep B either from getting the 3 vaccinations or from being exposed to the virus and fighting it off yourself.

How do you get treated for Hep B?

ACUTE HEP B

If there’s a good chance that you’ve been exposed to Hep B you should see your doctor immediately for preventative treatment. If you haven’t been vaccinated against Hep B and the exposure to Hep B was very recent (within the last 3 days) you can be given Hepatitis B immunoglobulin and the Hep B vaccine to prevent Hep B infection. Apart from this preventative treatment, there is no specific treatment for acute Hep B other than keeping as strong and healthy as possible to support your liver while your body’s natural defences fight the virus. As mentioned earlier, if you’re over 15 when you first get Hep B, you have a 95% chance of clearing the virus without treatment, but given that

5% of people infected go on to develop Chronic Hep B and many people with acute Hep B get really sick, your best bet is to be vaccinated.

CHRONIC HEP B

Not everybody who has chronic Hep B will need treatment, but when treatment is given the aim is to decrease the damage to the liver rather than to clear the virus. Your doctor can refer you to one of many special liver clinics located at major public hospitals. You don’t have to pay for this treatment because it’s funded by the government. It’s important to remember that there’s a lot you can do to keep yourself healthy. By eating good food and minimizing your drug and alcohol intake, you put less strain on your liver, meaning less damage to your liver and therefore less pain and discomfort for you. And be sure to protect yourself from other viruses that affect the liver such as Hep A and Hep C.

You can greatly reduce your risk of getting Hep C by never sharing injecting equipment and avoid Hep A by being vaccinated.

If you’re over 15 when you first get Hep B, you have a 95% chance of clearing the virus.