Introduction

Hepatitis is inflammation of the liver. This can be caused by alcohol and some drugs, but usually it is the result of a viral infection. There are many types of virus which can cause hepatitis. Each of these viruses acts differently.

The hepatitis B virus (HBV) is very common worldwide. It is very infectious.

The virus can be spread in the following ways:

• by unprotected (without a condom) penetrative sex (when the penis enters the anus, vagina or mouth) with someone who is infected. Also by sex which draws blood with someone who is infected
  
  

• by sharing contaminated needles or other drug-injecting equipment
  
  

• by using non-sterilised equipment for tattooing, acupuncture or body piercing
  
  

• from an infected mother to her baby, mainly during delivery. Immunisation of the baby at birth prevents the transmission of hepatitis B
  
  

• through a blood transfusion in a country where blood is not tested for the hepatitis B virus. All blood for transfusion in the UK is tested.
  

Signs and symptoms

People may have no symptoms at all, but they can still pass on the virus to others. Symptoms may include:

• a short, mild, flu-like illness
  
  

• nausea and vomiting
  
  

• diarrhoea
  
  

• loss of appetite
  
  

• weight loss
  
  

• jaundice (yellow skin and whites of eyes, darker yellow urine and pale faeces)
  
  

• itchy skin.

Some people may need to be admitted to hospital.

Most adults infected with the hepatitis B virus fully recover and develop life-long immunity.

Between 2% and 10% of individuals infected as adults will become chronic carriers, which means they will be infectious to others and can develop chronic liver damage. Infected children, especially new-born babies, are much more likely to become chronic carriers.

If a person continues to be infected over a number of years with the hepatitis B virus, they could develop the following complications:

• chronic hepatitis
  
  

• liver cirrhosis
  
  

• liver cancer
  

Diagnosis and treatment

Your GP or doctor at an NHS sexual health (GUM) clinic can diagnose hepatitis B by carrying out blood tests. You will be asked questions to try to discover the source of the infection.

What does a positive test result mean?

It could show:

Past infection. This means that you have been in contact with HBV and your body has rejected it. You now have a natural protection against the virus.

Carrier. This means that you carry HBV and can pass it on to others. You are at risk of chronic liver disease and may be referred to a specialist centre for further assessment.

A positive result can be confirmed by further tests and referral to a specialist. To find out how much hepatitis B may be affecting the liver, and what may be the best treatment for this, a small sample of liver tissue may need to be taken (a liver biopsy).

What does a negative test result mean?

This result means you have never been in contact with HBV and have no natural protection against it.

If there is a chance you have been recently exposed to the virus, your doctor may advise you to have a repeat test and be immunised against hepatitis B.

Many people do not require treatment, as the inflammation of the liver may not be severe. If you need treatment for liver inflammation, you will be referred to a specialist centre for a full assessment.

Follow-up and prevention

If you are diagnosed as having an active infection with hepatitis B, you will be advised to have regular blood tests and physical check-ups. All carriers should expect to be referred to specialist services.

If you are infected with hepatitis B, you should limit the amount of alcohol you drink. The doctor may also advise you to avoid fatty foods and follow a low-salt diet.

If you have hepatitis B, you should use a condom for penetrative sex to prevent passing on the virus.

Your partner should also be immunised against hepatitis B ( if not already infected).

Your doctor will advise you about any precautions necessary to ensure that you avoid infecting others with the virus, such as not sharing toothbrushes or shaving equipment.

Remember, using condoms can reduce your risk of getting or passing on sexually transmitted infections.

Immunisation

Three injections are given over a period of 3-6 months. A blood test is taken once the course of injections is completed to check that they have worked. Immunity should last for at least 5 years.

The injections are available at your local NHS sexual health (GUM) clinic, or from your GP.

Further Information

British Liver Trust
Portman House, 44 High Street, Ringwood BH24 1AG
Tel: 01425 463080
Website: www.britishlivertrust.org.uk

Masta (Medical Advisory Services for Travellers Abroad)
Moorfield Road, Yeadon, Leeds LS19 7BN
Tel: 0113 238 7575
Website: www.masta.org

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Always consult your own GP if you are in any way concerned about your health.