Hepatitis B

Hepatitis B is a liver infection caused by a virus carried in the blood and other body fluids.

How do you get hepatitis B?

It’s usually passed on through blood-to-blood contact. This could happen if you:

  • share needles when injecting drugs

  • are injured by a used needle

  • share a razor or toothbrush that has infected blood on it

  • come into contact with unsterilized equipment when getting a tattoo or piercing

  • have a cut on your skin that comes into contact with infected blood

It can also be transmitted through unprotected vaginal or anal sex.

If you’re pregnant and have hepatitis B, it can be passed on to your baby. But the infection can be stopped if the baby is vaccinated immediately after birth.

The chance of getting hepatitis B in the UK is low. In some parts of the world, the risk is higher, these include:

  • Africa

  • Asia

  • the Middle East

  • parts of South America and Eastern Europe

Symptoms of hepatitis B

During the early stage of infection, there may not be any symptoms.

You should seek immediate medical advice if you think you’ve been exposed to hepatitis B. It’s possible to stop the infection if you get treatment straight away. This is most likely to work in the first 48 hours after exposure.

If symptoms do develop, it’s usually within 6 months of infection. They can include:

  • flu-like symptoms like muscle aches and high temperature

  • feeling tired all the time

  • depression

  • 1 in 5 people will experience yellowing of the eyes and skin (jaundice)

  • patches of raised, itchy skin

  • loss of appetite and weight loss

  • sickness and diarrhoea

Most people recover fully after this initial stage. Once clear, they’re then immune to the infection and are not infectious.

You can only be certain you have hepatitis if you have a test.

If you have any symptoms of hepatitis B, you should visit your GP or local sexual health clinic.

Getting tested for hepatitis B

Getting tested is the only way to find out if you have hepatitis B. You can get tested at your nearest clinic, or you can order a test to do at home.

This test uses a blood sample that's sent to a laboratory to be tested. You can have this test done in a clinic or use a kit at home to take your own sample.

If you’re doing a home test, you canto see how it works.

Hepatitis B can take from 12 weeks to 6 months after infection to show up in a test. If you're testing after a potential risk, you should test at 3 months and then again at 6 months after the possible exposure.

If you’re not sure when you might have been exposed, or how long to wait, the best thing to do is take a test now. Then test again in 3 months and 6 months for accurate results.

Our hepatitis B tests are not suitable for:

  • checking that recent treatment for hepatitis B has worked

  • finding out your level of immunity after being vaccinated

  • anyone who’s had hepatitis B in the past and been treated

There are different types of hepatitis B tests and they look for different things. With an SH:24 test, we will first test for the hepatitis B core antibody. Any samples that get a positive result in this test are then tested again, this time for the hepatitis B surface antigen. This tells us if the infection is an active infection or an old infection.

If you get a negative result in the first test, this means there are no signs of the infection. We do not test these samples for the surface antigen.

How to avoid hepatitis B

  • never share drug-injecting equipment (this means syringes, spoons and filters as well as needles)

  • don’t get tattoos or piercings from unlicensed places

  • don't share razors, toothbrushes or any personal care items that could have blood on them

  • use a condom, especially with a new partner, including for anal and oral sex

  • wash sex toys or cover them with a fresh condom before sharing with another person

You can get free condoms at sexual health clinics.

Vaccination

A vaccine for hepatitis B is available on the NHS. It’s recommended for anyone at high risk of infection. People might be eligible for the vaccine if they:

  • live with, or are close to, someone who has hepatitis B

  • have liver or kidney disease or HIV

  • are travelling to a higher risk country

  • inject drugs

  • are a sex worker

  • are a man who has sex with men

If any of these describe you and you have not been vaccinated, you should get tested for hepatitis B.

Is hepatitis B serious?

All sexually transmitted infections can be serious if they’re not treated quickly.

Most people don’t have long term problems from hepatitis B. But if it’s not treated, chronic hepatitis – when an infection lasts more than 6 months – can cause liver damage (cirrhosis) and increase the risk of liver cancer.

Treatment for hepatitis B

Hepatitis B can be managed at home in the early stages with over-the-counter painkillers like paracetamol. You may be prescribed codeine if your pain is more severe. It usually clears in 1–3 months.

Some people find their body cannot clear the infection. If you have chronic hepatitis you may still be symptom-free a lot of the time. But your doctor may send you for tests to see how well your liver is working. And you may need to take medication to prevent liver damage. There are now very effective medicines that can suppress the virus.

Telling other people

If you’re diagnosed with hepatitis B you should tell the people you live with or you've recently had sex with so they can be vaccinated. If there's any chance you've had blood-to-blood contact with someone, like sharing needles and other drug taking equipment, then you should tell them too.

It can be hard to work out who to tell and how to have that conversation, so it’s best to talk about it with your doctor. They can help and give you advice.

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