The Hepatitis B virus spreads through contact with infected body fluids. Chronic hepatitis B infection increases the risk of serious liver disease, including liver cirrhosis and liver cancer.
An estimated 350 million people world-wide are infected with the hepatitis B virus. Hepatitis B is especially common in Africa, Asia, parts of South America, northern Canada, and Alaska. Data from 2010 show approximately 120 million infected individuals in China, 40 millions in India and 12 million Indonesia. In Northern Europe, less than 1% of the population is infected.
Vaccination against Hepatitis B
If you live in the United Kingdom and belong to any of the following groups, you may want to consider being vaccinated against hepatitis B:
- People traveling to high-risk countries.
- Families adopting or fostering a child from a high-risk country.
- People with chronic kidney disease or any form of liver disease.
- People who receive regular blood transfusions or blood products.
- People who have a close family member that is infected.
- People who have sex with someone that is infected.
- People who change their sexual partners frequently.
- Men who have sex with men.
- People who have an increased risk of coming into contact with body fluids when they work, such as MD:s, nurses, dentists, laboratory staff, prison staff, and sex workers.
- People who inject illegal drugs, especially if sharing needles with others.
- People who have a sexual partner partner or close family member that injects illegal drugs.
- Prisoners.
- If the mother is infected with hepatitis B, the newborn child should be vaccinated.
Where?
You can ask your GP to vaccinate you, or go to any sexual health or genitourinary medicine (GUM) clinic.
If it is your work that places you at risk of hepatitis B infection, it is your employer’s responsibility to arrange the vaccination for you.
Cost
Vaccine for hepatitis B only, and combined vaccine for both hepatitis A and hepatitis B, are usually available for free on the NHS. There are a few exceptions though, including the following:
- Your GP is not obliged to provide you with the hepatitis B vaccine on the NHS if the GP doesn’t think you belong to a high-risk group.
- Your GP may charge for the hepatitis B vaccine if you want it because of travel. You may also be referred to a private travel clinic.
- If it is your work that places you at risk of hepatitis B infection, it is your employer’s responsibility to arrange vaccination for you.
The cost of the vaccine is typically around £40 per dose, but the exact price can vary from one clinic to another and also vary depending on which brand and type you receive.
How?
The most commonly employed vaccination schedule for hepatitis B in the United Kingdom consists of three injections given over a period of four to six months. Thereafter, five-year boosters are recommended to keep the protection.
For some groups, a follow-up exam is offered where you will be checked to see if you have achieved adequate protection. Such a follow-up exam is for instance offered to health care workers and people with kidney disease.
Hepatitis B vaccination & pregnancy
Hepatitis B vaccination is administered to pregnant women if the woman is in a high-risk category for hepatitis B infection. There is no evidence of any risk from vaccinating pregnant women against hepatitis B. The vaccine contains a dead virus, not a live one.
Hepatitis B vaccination & breastfeeding
Hepatitis B vaccination is administered to breastfeeding women if the woman is in a high-risk category for hepatitis B infection. There is no evidence of any risk from vaccinating breastfeeding women against hepatitis B. The vaccine contains a dead virus, not a live one.
Babies born to infected mothers
In the United Kingdom, pregnant women are routinely tested for hepatitis B as a part of the antenatal care. If the mother is infected, the child should be given one dose of hepatitis B vaccine within 24 hours after birth. The newborn should then receive three additional doses; one dose when it is 1 month old, one dose when it is 2 months old, and one dose when it is 1 year old. In addition to this, the child can be given an injection of HBIG (anti-bodies against hepatitis B) soon after birth to provide it with ready-made antibodies that can serve as protection until the body responds to the vaccine.
Emergency hepatitis B vaccination
If you know or suspect that you have been exposed to the hepatitis B virus, seek immediate medical attention unless you are already properly vaccinated against the disease. You can be given an injection of HBIG (anti-bodies against hepatitis B) to provide immediate protection, and then be vaccinated to provide longer protection. HBIG should ideally be administered within 48 hours after exposure to the virus, but may have a protective effect even if given up to one week after exposure.
Combination vaccine
Hepatitis B vaccination is available in the form of a combination vaccine that will protect against both Hepatitis A and Hepatitis B. Since it is much easier to catch Hepatitis A (spreads through food, drink, etc) than Hepatitis B (spreads chiefly through blood and sex), it is usually a good idea to get vaccinated against both instead of just Hepatitis B if you are traveling to a country where both diseases are common.
Side effects of hepatitis B vaccination
The hepatitis B vaccination contains a virus that is no longer alive, and side effects are rare, except for some brief redness, swelling and soreness at the site of the injection.
About hepatitis B
Hepatitis B is caused by the hepatitis B virus (HBV).
Acute hepatitis B can lead to chronic hepatitis B, which increases the risk of liver cirrhosis and liver cancer . To prevent this, anti-viral treatments are available for those infected with the hepatitis B virus. Anti-viral medication can also be used to combat chronic hepatitis B and decrease the risk of complications.
The younger you are when infected with hepatitis B, the higher your risk of developing chronic hepatitis B. Without medical intervention, a newborn infected with hepatitis B have a 90% risk of developing chronic hepatitis B.
It is possible to have chronic hepatitis without having any noticeable symptoms.
Catching hepatitis B
In an infected individual, hepatitis B virus can be present in the blood and several other body fluids. A person can be contagious even when no symptoms of acute or chronic hepatitis B are present.
There are no reports of anyone catching hepatitis B from urine, vomit, snot or tears – unless those fluids were mixed with blood or genital fluids. The same is true for feces
The chief transmission of hepatitis B is through blood and through sexual intercourse (vaginal, anal or oral). Getting the virus on your skin is not enough to be infected; the virus needs a wound or a mucous membrane to penetrate into the body. Please note that even a very small wound will be enough, even a scratch or tear that is barely visible to the naked eye. Also remember that the eye is a mucous membrane.
Examples of situations that can be risky:
- Sex
- Getting a tattoo or a piercing (if proper hygiene procedures aren’t adhered to)
- Sharing an injection needle
- Receiving a blood transfusion or other blood products
- Getting someones blood on a wound or mucous membrane, e.g. because of traffic accident, assault, etc.
- Health care where proper hygiene procedures aren’t adhered to
- An infected mother can infect her child at birth
Symptoms
Many of those who are infected with the hepatitis B virus notice no symptoms, or develop only mild symptoms that can easily be confused with influenza
The incubation period for hepatitis be is normally 60 days – 150 days.
Examples of symptoms of hepatitis B
- Fever
- Fatigue
- Loss of appetite
- Nausea
- Vomiting
- Muscle aches
- Stomach pain in the liver region
- Itchy skin
- Yellowing of the skin
- Yellowing of the eyes
- Dark urine
- Clay-colored feces
Treatment
- Hepatitis B is treated with anti-viral medication. You can also get treatment for the various symptoms, e.g. anti-itch medication if your skin is itchy.
- While your liver inflamed, it is important not to tax it with toxins. Keep away from alcohol and other drugs. Also remember that many medicines must be avoided, including certain over-the-counter medicines such as paracetamol.
