Managing your Hepatitis B

Join the hepatitis B programme

Hepatitis B requires long-term monitoring. Having six-monthly blood tests is very important. To help you look after yourself you can enrol on to the national hepatitis B monitoring programme. This programme provides information and support for people with chronic hepatitis B. You will be given regular blood tests as needed, education, advice, up-to-date information, contact with a community hepatitis nurse and access to secondary care if needed.

Look after your liver – maintain a healthy lifestyle

You can keep healthy by:

  • Staying within a healthy weight range
  • Avoiding food and beverages containing a lot of fat or sugar
  • Exercising daily
  • Maintaining a healthy, well-balanced diet
  • Getting checked for diabetes and if you have it follow your doctor’s advice.

For more detail please read our information sheet about hepatitis and lifestyle.

f49296ee48900a1e8cd0bd70fdd73298_f900Drinking less alcohol is the most important lifestyle change you can make. Anyone with hepatitis B is recommended to keep alcohol intake to a minimum to reduce the risk of developing hepatitis-related complications. Regular and heavy alcohol intake will increase liver damage and increase your risk of cirrhosis

Cannabis use should also be reduced as heavy cannabis use can scar your liver.

Also avoid eating fatty foods as they clog your liver and stop it working.

People with hepatitis also need to mindful about taking pain relief medication. Please read the article ‘Pain relief and your liver‘ from issue 12 of Talking Hep C.

This will help you cope better with hepatitis B and will also help avoid other liver problems such as fatty liver disease. Fatty liver is a condition where excess fat builds up inside the cells within the liver. Fatty liver may speed up the progression of scarring in people with chronic hepatitis B.

Managing your symptoms

If you experience symptoms such as no energy, low concentration or not wanting to exercise or eat, you can do simple things to help such as:

60e45f41d01430b8eceb45b2bdb87f8d_f934•Doing some gentle exercises every day
•Planning ahead and doing more when you have more energy
•Eating smaller meals
•Resting when you feel tired instead of trying to sleep
•Having a pre-sleep routine
•Not exercising or drinking coffee or tea before bed
•Not napping during the day.

Blood test monitoring

Blood tests can detect liver disease and should be done six-monthly. These tests include:

  • HBsAg: Hepatitis B surface antigen
  • HBeAg: Hepatitis B envelope antigen
  • ALT: screen for active liver inflammation (and possible need for antiviral therapy)
  • AFP: screen for hepatocellular carcinoma (HCC). Please note that this will also be elevated during pregnancy.
  • HBV DNA: measures the amount of virus present in the blood. May be requested every few years.

Please read our information sheet for more detail about liver function tests.

If repeated blood tests show the ALT level is up and the virus level is high, treatment may be recommended.

A Fibroscan is also useful when deciding if treatment is needed.

FibroScan

a560ebfae5ced65fd71d4acb9b17d5ca_f817Having a FibroScan is one of the most important things you can do to assess the health of your liver.

A FibroScan is a simple, painless test that determines if there is any scarring present in the liver. Scarring is described as fibrosis or cirrhosis. The Fibroscan assessment usually takes between 10 and 15 minutes and the results of the scan are available straight away. In a small number of people the Fibroscan test may not work or the result may be unreliable. The most common cause of a failed test is being overweight (obese).

You can have a FibroScan if:

  • You have hepatitis B or C.
  • You are enrolled with The Hepatitis Foundation of New Zealand,
  • A FibroScan clinic is available in your area. Please call 0800 33 20 10 for information about where these clinics are held.

What do your results mean?  

The Fibroscan result will be a number between 1 and 75 kPa. Numbers <7 suggest there is no damage in the liver. Numbers between 7 and 11 suggest some scar tissue may be present in the liver. This is described as fibrosis. It could be mild, moderate or severe. If the result is greater than 11 it is likely the liver has cirrhosis.

The term cirrhosis describes a liver where much of the normal tissue has been replaced by scarring. The structure of the liver has been permanently damaged. Once a person has cirrhosis  they are at risk of going into liver failure or developing liver cancer. Cirrhosis can be caused by anything that causes damage or inflammation to the liver over many many years. Some causes of cirrhosis include: alcohol, viral hepatitis A, B, or C, fatty liver, iron overload (hereditary haemochromatosis) and there are many more.

Fibrosis means that there is some scarring present in the liver. But the damage is not permanent and there is not enough of it to cause liver failure. After the virus is cured the liver can improve.

If you require a FibroScan for immigration purposes click here. 

Read the article ‘An in-depth look at the FibroScan‘ from issue 11 of Talking Hep C for more information.

Telling others

While you do not have to tell anyone about your diagnosis, reasonable precautions must be taken to avoid passing it on to others (see above for ‘preventing the spread’). It is often best to tell people you trust or people directly affected, such as household members or sexual partners.

People living with hepatitis B do not have to tell employers, unless you work in an environment that may put others at risk, such as healthcare. Discrimination against people with hepatitis in the workplace is illegal.

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 B or not.

 

Preventing the spread

9d9c90776f3dbd68b1e8d59b963bfeaf_f905Hepatitis B is spread by transfer of infected blood and other bodily fluids from one person to another. To avoid infecting others you should take the following steps:

  • Cover any open cuts or sores
  • Clean any blood spillage with household bleach (do not put bleach on your skin)
  • Do not donate blood
  • Practice safe sex- use condoms until your partner has evidence of protective immunity
  • Vaccination for sexual contacts and household members (free vaccine is available)
  • Do not share razors, towels, toothbrushes, or any object that may come into contact with blood or body fluid.

Hepatitis B is not spread through everyday contact, e.g. touching, sneezing, coughing or using the same toilet.

Testing of family members and contacts

Hepatitis B testing and a vaccination should be offered to household contacts and sexual partners of people with hepatitis B. Since 1987, all babies born in New Zealand have been protected against the hepatitis B virus infection through vaccination. Hepatitis B is very rare in New Zealanders younger than 25 years.

© The Hepatitis Foundation of New Zealand 2016