Hepatitis B (HBV)
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What is Hepatitis B?
Hepatitis B is an infection caused by a virus which attacks the liver.
Approximately 90% of people who contract HBV will eliminate it naturally from their bodies. The remaining 10% will become chronic carriers, and the HBV will remain permanently in their bloodstreams and bodily fluids.
How do you get Hepatitis B?
HBV may be transmitted via contact with the following fluids: sperm, vaginal secretions, blood or saliva:
- By at-risk sexual contact;
- By blood-to-blood contact in the following situations:
- Sharing drug inhalation implements or needles;
- Touching an open wound;
- Tattooing or piercing with contaminated equipment;
- Sharing sex toys;
- An infected mother may transmit the virus to her baby during pregnancy or childbirth.
Sharing syringes, razors, toothbrushes, and unsterilized body piercing or tattoo needles can result in the transmission of the Hepatitis B virus.
Chronic carriers of Hepatitis B may transmit the virus their entire lives.
Non-chronic carriers may transmit the virus for a duration of approximately 6 months - from the moment they become infected until they eliminate the virus from their system.
What are the symptoms of Hepatitis B?
There are no apparent symptoms at the beginning. Often symptoms develop within two (2) to six (6) months after contact with an object or a person infected with the virus.
Some of the following may occur:
- Loss of appetite, nausea, vomiting
- Extreme fatigue
- General feeling of discomfort
- Jaundice (yellowish coloration of the eyes and skin)
- Stomach ache
- Dark urine and pale stools
These symptoms may be very intense, but they disappear on their own after several weeks, without any long-term effects on the liver. Almost one third of HBV carriers are asymptomatic, and therefore are not aware that they are infected and that they may transmit the virus.
What are the possible complications of Hepatitis B?
10% of people infected with HBV will go on to develop chronic Hepatitis B.
They may ultimately develop cirrhosis of the liver or liver cancer.
1% of cases will develop fulminant Hepatitis, leading to death.
How is Hepatitis B diagnosed?
Hepatitis B is diagnosed by a blood test following the appearance of symptoms.
A blood test will give you one of the following results:
- A completely negative result indicates that you have never been exposed to or that you have never been immunized against the Hepatitis B virus. If this is the case, you could benefit from immunization.
- A positive antibody test (anti-HBs) indicates that you have been infected at one time in the past and that you are now completely cured, or that you have been successfully immunized against Hepatitis B and you will never contract the virus or infect anyone. There are several Hepatitis B antibodies, but only the anti-HBs guaranties total immunity.
- A positive antigen test (AgHBs) indicates that you will always be a carrier of the Hepatitis B virus. The presence of the virus may signify either an acute (recent, spontaneously cleared) or chronic (long-lasting) infection. If the virus is in your blood for longer than six months, you have a chronic infection, and are a carrier of the Hepatitis B virus.
What is the treatment for Hepatitis B?
This form of Hepatitis may go away on its own. Therefore, it is important for patients to heal themselves by getting lots of rest, eating properly and avoiding alcohol and drugs, which put increased strain on an already unhealthy liver. In 90% of cases, the patient will develop protective antibodies against the virus.
For chronic carriers of the virus:
- Regular medical follow-up visits are essential.
- The vaccine for Hepatitis A (the virus that also attacks the liver) is recommended.
Treatment may limit the severity of the infection, and, in some cases, may result in a complete cure.
How can Hepatitis B be prevented?
- Practice safe sex;
- Avoid blood-to-blood contact;
- The Hepatitis B vaccine is recommended for people under the age of 18, and to people who are considered at risk of contracting this virus due to their sexual behaviour or their exposure to contaminated food. At-risk groups include:
- People who engage in at-risk behaviours;
- Partners of persons living in the same household as people infected with Hepatitis B;
- Intravenous drug users;
- People requiring frequent blood transfusions or blood products;
- Organ transplant recipients;
- People at risk for occupational exposure, such as health-care workers;
- Travelers to regions with high infection rates of Hepatitis B.
What are the risks for HIV-positive people?
If you are HIV-positive, you run a greater risk of becoming a chronic Hepatitis B carrier. It is possible that the effectiveness of your HIV treatment may be complicated or reduced if you have Hepatitis B.
In Quebec the Hepatitis B vaccine is administered in 3 doses, with the second injection at least one month after the first dose, and the third injection given six months after the first. An accelerated schedule of vaccination can be administered in only two doses.
The vaccine is free for youth and men who have sex with men.
There is also a combined vaccine that immunizes against both Hepatitis A and Hepatitis B, and the dose is the same as that of only HBV.
Reporting of Hepatitis B is compulsory. Public health professionals who diagnose Hepatitis B must inform the Public Health Department of their region.