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Hepatitis B

Hepatitis B is a condition causing inflammation of the liver. It can be a self-limiting issue that resolves independently (acute Hepatitis B), or it may worsen and progress into cirrhosis of the liver (chronic Hepatitis B). If left unchecked, in some instances it can even develop into cancer.

The hepatitis B virus is the most widespread type across the world. It is primarily transmitted through blood and other bodily fluids. There is a higher rate of contracting the virus among individuals who engage in unsafe sex practices, have multiple partners, and/or are injection drug users.

In the UK, it has been estimated that around 180,000 people are living with a chronic infection, wherein they have had an active infection for six months or more. A test for a hepatitis B surface antigen (HBsAG) is done and there will be a persistent positive result in these individuals.

While it is not necessarily an endemic disease in the UK, there has been a steady increase in the number of individuals being diagnosed with hepatitis B. Therefore it is important to be aware of it.

Initial symptoms of hepatitis B infection may not be obvious, or mistaken for the flu. In individual cases where a medical history gives reason to suspect hepatitis B infection, a blood sample will be taken and screened for the presence of antigens to the virus. If the sample is to confirm an active infection , the person will be started on appropriate treatment accordingly.


What are the symptoms of Hepatitis B?

Someone infected with Hepatitis B may not necessarily present with any symptoms. Alternatively, they may experience incredibly mild symptoms, which often will be neglected. Often, individuals who fall sick would present with symptoms similar to the flu and may not necessarily get tested for Hepatitis B.

The most common symptoms of a Hepatitis B infection are as follow:

  • Fever
  • Extreme fatigue and myalgia (general body pain/aches)
  • Joint pain
  • Abdominal pain/tenderness
  • Loss of appetite
  • Nausea/vomiting
  • Irregular, pale-coloured bowel movements
  • Headache
  • Hives
  • Yellow coloured skin and/or eyes due to jaundice

Infected people will recover but there may be chronic liver damage. Individuals who contract the virus, but do not develop Hepatitis may become long-term carriers of the virus.

Can you have Hepatitis B without having any symptoms?

Someone infected with Hepatitis B may not necessarily present with any symptoms. Alternatively, they may experience incredibly mild symptoms, which often will be neglected. Often, individuals who fall sick would present with symptoms similar to the flu and may not necessarily get tested for Hepatitis B.

Chronic Hepatitis

Most people infected with Hepatitis B will recover without any issues; however, one in twenty people who get infected as adults become carriers of the virus, resulting in a long-lasting infection.

Carriers may pass on the infection to others, which is why they should have routine follow-ups with their doctor and be educated on proper management and care; for example - regular screenings to check their viral titres to monitor the presence of antibodies to the virus.

These individuals are also at a higher risk of developing certain conditions like liver cirrhosis or liver cancer.

Keep in mind that medications are available to help treat Hepatitis B infections.

When do symptoms of Hepatitis B start to appear?

Most sick individuals will show symptoms anywhere between 6 weeks to 6 months of being exposed to and contracting the virus. Symptoms typically last for a few weeks but, in some instances, may last for months at a time.

What complications can Hepatitis B lead to, if untreated?

If Hepatitis B is left untreated for a long period of time, it can lead to cirrhosis (scarring) of the liver, which may impair the liver's ability to function adequately and also potentially lead to liver cancer. This highlights the importance of people in high risk groups practicing safe sex with new/casual partners, considering vaccination and also taking part in routine screening.


How do you get Hepatitis B?

It is caused by the Hepatitis B virus which attacks the liver, you can contract it via the following methods:


Sexual contact

Hepatitis B virus is present in blood, semen, vaginal secretions (and saliva, although the virus is not thought to be transmitted through kissing or sharing kitchen utensils)

Mother/Parent to Baby

Pregnant mothers/people infected with the Hepatitis B infection can potentially pass the virus onto the newborn baby during delivery. If the baby is vaccinated shortly after delivery then the chances of them becoming infected in very low. This highlights why it is important for pregnant women/people in a high risk group to get tested for Hepatitis B whilst pregnant.

What factors can increase the likelihood of getting Hepatitis B?

  • People who engage in unprotected vaginal, anal or oral sex
  • People who have had a multiple sexual partners
  • People who have had sex with someone from a high risk (endemic) area
  • Commercial sex workers
  • Those with close friends or family who have a chronic Hepatitis B infection
  • People who inject drugs/share needles
  • People born/brought up in a country where the infection is common
  • Babies born to mothers who have the virus

Think you might have Hepatitis B?

Require protection against Hepatitis B?


What is the treatment for Hepatitis B?

Hepatitis B is a potentially life-threatening liver infection caused by the Hepatitis B virus (HBV). According to WHO (World Health Organisation) it is a major global health problem. It can cause a chronic infection that puts people at high risk of death from cirrhosis and liver cancer.

Treatment for viral Hepatitis should be initiated by a specialist. The management of uncomplicated acute viral Hepatitis usually involves symptomatic supportive care. Early treatment of acute Hepatitis B may reduce the risk of chronic infection and the progression into liver disease. In many cases this infection might stay asymptomatic, therefore it is important to get tested.

There are several groups of drugs approved for use in treating Hepatitis B. These drugs fall into two categories:

  • Immune modulator drugs: This medication works by boosting your immune system to help fight the virus. It is typically given as a shot (similar to how insulin is administered), and is given over the course of 6 months to 1 year.
  • Antiviral drugs: This medication slows the rate of reproduction, which in turn, reduces the damage done to your liver. This is usually given as an oral tablet to be taken once a day.

The duration of treatment depends on several factors including the response to treatment (e.g. viral suppression, antigen loss, seroconversion), patient characteristics (e.g. liver disease), and treatment tolerability. Treatment is usually continued long-term in patients with decompensated liver disease.

Can Hepatitis B be cured?

Most adults infected with Hepatitis B can fight off the infection in a few months and will recover on their own, with no lasting liver damage. In rare cases people might develop chronic hepatitis B infection, which may lead to cirrhosis and liver cancer.

Although there is no cure for the infection itself, we can protect ourselves against it by getting vaccinated.

How do I know if I am eligible for treatment?

Treatment is not recommended for all people with Hepatitis B.

Acute Hepatitis B is usually self-limiting, meaning the infection resolves naturally, on its own. Treatment to relieve the symptoms can be offered such as general pain killers and medicine to prevent you from feeling nauseous or sick.

Chronic Hepatitis B is treated using antivirals as well as medication to relieve symptoms such as nausea, itchiness, and pain. You may also need to regularly see a liver specialist to check the status of your liver. However, even those who have chronic Hepatitis B may not receive treatment straight away as your health specialist may opt to monitor your condition before offering you treatment.

Why do we need to treat Hepatitis B?

Hepatitis B infection needs to be treated as it is an infectious viral disease that can lead to cirrhosis and liver cancer in the long-term.

Is there anything I can do at home if I have Hepatitis B infection?

  • Boost your immune system.
  • Avoid drinking alcohol.
  • Develop a healthy diet that consists of fruits, vegetables, whole grains, fish and lean meat.
  • Avoid an unhealthy diet that consists of fatty, greasy food, sugary drinks, and processed food that contains brown or white flour.
  • Stay hydrated and rest well.

What do I do if I think I am reacting badly to the treatment?

Contact your local healthcare provider or call 111. In cases of a possible emergency, please call 999.

Will taking immune boosting supplements help?

There is a very good chance that it will help. However there is not enough scientific evidence to provide a clear answer on the impact of immune boosting supplements, therefore, it is not recommended to solely rely on these supplements to manage your infection.

Will the treatment affect me and my baby during pregnancy and after birth?

There is little research available on the impact of treatment on pregnant women and developing fetus’. However, this will need to be discussed with the doctor or midwife overseeing your pregnancy.

How effective is the treatment for Hepatitis B?

The specialist managing your care will walk you through the effectiveness of treatment as it can vary depending on person and treatment type.

Do I need to stay on treatment for my entire life?

It is possible that you will need to stay on your treatment for the rest of your life if you have chronic Hepatitis B.

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Reviewed by: Ms. Magda Novacka
Written By: Shannon Abraham

Last reviewed date: 14 February 2023
Next review due: 14 February 2026

Whilst this content is written and reviewed by sexual health specialists, it is for general guidance only. It is not intended to replace the advice of your clinician.