Hepatitis B (HBV) is a virus that is spread through contact with blood or bodily fluids of an infected person. The infection leads to inflammation of the liver.
Acute hepatitis B occurs when a person is infected with the hepatitis B virus for less than six months. Chronic hepatitis B is a long-term infection which lasts more than six months and needs regular follow-up.
The virus causes inflammation of the liver, which affects the way the liver works. The liver is a very important organ which does many tasks essential for life and growth. Hepatitis B causes scarring of the liver and over many years can result in cirrhosis, which stops the liver working properly. Liver damage can also lead to liver cancer or liver failure.
Many people with chronic hepatitis B have no symptoms. It is often referred to as the ‘silent epidemic’ because it’s common for people not to notice any symptoms until 20 or 30 years after infection. However, symptoms that do appear are usually mild and non-specific. The most common symptoms include:
There are two tests used to diagnose hepatitis B:
The HBsAG surface antigen tests whether you have ever been in contact with the virus. The Anti-HBc tests if you have been infected with the virus in the past. In order to consider an individual to have chronic hepatitis B, a further confirmatory test six months later is required.
Hepatitis B is the most common serious liver infection in the world. It is the leading cause of liver cancer. About 100,000 people in New Zealand are chronically infected with the virus. Every year over one million people die from hepatitis B related liver disease, which includes 200 to 300 people in New Zealand.
Hepatitis B is spread through contact with blood or sexual fluids. It is highly infectious and can survive outside the body for more than seven days. The age a person is infected is very important in determining whether the person gets sick and whether they clear the infection.
About 99% of people with chronic hepatitis B were infected as babies or young children. The most common way babies get infected is from their mother during birth. The most common way young children get infected is from playing with other children who have hepatitis B or by close contact with a hepatitis B household member. When young children and babies get infected, they develop chronic infection with the associated life-long risks of cirrhosis, liver failure and liver cancer.
When adults are infected, they often become sick with acute hepatitis (jaundice, abdominal pain and vomiting) but usually get rid of the infection.
You do not have to tell anyone you have hepatitis, however, you should take reasonable precautions to prevent the spread of the virus to others.
You may choose to share your diagnosis with particular people for support. It is often best to tell people you trust or people directly affected, such as household members or sexual partners.
Telling healthcare workers such as a doctor or nurse may be beneficial for good health care (e.g. prescribing the most appropriate medications). Health care workers, including dentists, are required to use standard infection control precautions for all situations and procedures that may involve exposure to blood or other bodily fluids, regardless of whether you have hepatitis or not.
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People living with hepatitis do not have to tell employers, unless you work in an environment that may put others at risk, such as healthcare. However, disclosure is not mandatory. Discrimination against people with hepatitis in the workplace is illegal. Read more about telling others here.
Hepatitis B is not spread through everyday contact such as:
Hepatitis B is spread mainly by transfer of blood and other bodily fluids from one person to another. To avoid infecting others you should take the following steps:
Yes, there is a safe and effective vaccine to protect against hepatitis B. The vaccination is made up of three injections over a three to six month period. Since 1987 a vaccination has been available to all babies born in New Zealand. The vaccination is free to all those under 18 years of age through general practitioners.
It is also offered free-of-charge to household contacts and sexual partners of people infected with hepatitis B. The vaccination is recommended (although not publicly funded) for many other at-risk groups such as health care workers.
Treatment for hepatitis B is only needed in people with high levels of virus and liver enzymes in the blood. The medicines control chronic hepatitis B by stopping the virus from multiplying. The treatment is a single tablet once a day. Once treatment has started it needs to be taken for the rest of a person’s life.
You should have regular blood tests every six months to check whether the hepatitis B has become active and whether you need treatment. Blood tests can also detect liver disease. Treatment helps prevent further damage and also reverses damage from liver scarring. To help you look after yourself, you can enrol in the Hepatitis Foundation’s National Hepatitis B Follow-up Programme. The Foundation will organise your blood tests to help with the health of your liver. You may not experience symptoms from the virus but that does not mean no liver damage is occurring. Regular blood tests may detect damage to your liver early and allow for treatment before you feel sick.
A FibroScan provides information about the health of your liver. It is a simple, painless test that determines if liver damage (fibrosis or cirrhosis) is present. It measures the degree of stiffness in the liver.
A liver biopsy is a procedure which involves taking a small sample of liver tissue and examining it under a microscope. In many cases, a FibroScan removes the need for a liver biopsy.