My partner got hepatitis B over 15 years ago. Does she still have the virus?
These are smart questions, and I can understand your concern. Kissing your fiancée doesn’t carry a high risk of catching hepatitis B from your partner...but the only way to know for sure it to get tested for hepatitis B.
You’ll gain the most insight about your fiancée’s health by talking with her and her doctor. However, I’m happy to offer you some thoughts on hepatitis B in general.
Your fiancée can talk to her doctor more about the results of her hepatitis B tests to learn if she may have a “resolved” infection. The “Australia antigen” more often called the Hepatitis B Surface Antigen (HBsAg) is a protein marker on the shell surrounding the hepatitis B virus. Hepatitis B tests look for this antigen. If the antigen is present (a positive result), it means that the patient is infected with HBV.
But there’s more to the story than HBsAg. Hepatitis B tests also look for two antibodies that are made by the body’s immune system in response to the hepatitis B virus. So, if a body has built up an immune defense against HBV, tests will show the presence of antibodies that lock onto hepatitis B antigens. These are called “anti-HBs” and “anti-HBc”.
This is where test results get a little tricky and need to be interpreted by a doctor...
Typically, if someone is positive for “anti-HBs,” it means they’ve developed an immunity to the disease and the infection is resolved.
If someone is negative for “anti-HBs” but positive for “anti-HBc,” the result could mean a number of things: that the infection is resolved, that there is a low-level chronic (long-term) infection, or that there is a resolving acute (short-term) infection. Of these possibilities, the most likely outcome is a resolved infection.
Even if your fiancée’s hepatitis B is resolved, the virus can come back. Your partner should follow the instructions from her doctor about continuing to monitor her health. As a precaution, she can also talk to her doctor about getting vaccinated for hepatitis A. And, just to give yourself peace of mind, you may want to talk to your doctor about getting tested for HBV, too. That way if you do happen to be positive for the virus, you could get treated, too.
Hepatitis B is not curable...but there is a vaccine to prevent the disease that’s routinely given to children, and most adults infected with the virus fully recover with antiviral medications.
What about starting a family? In general, HBV is passed from person to person through unprotected sexual activity, or from sharing syringes, needles, razors or toothbrushes. As well, mothers infected with HBV run the risk of passing the virus to their babies during childbirth. That’s why it’s very important that you and your fiancée talk to her doctor when you’re ready to start a family...pregnant women can be treated with a neonatal vaccination to reduce the risk of HBV transmission to their baby.
Finally, the Centers for Disease Control and Prevention recommend that anyone living with a person who has hepatitis B get vaccinated. If you haven’t already been vaccinated for hepatitis B,talk to your doctor about the HBV vaccine. In the meantime, be sure to practice safer sex by using a latex condom for vaginal and anal sex, and a condom or dental dam for oral sex. Also, check out these guidelines for living with someone with HBV that I discussed in a different question.
You can also find out more about hepatitis B risks, complications, testing and treatment in our Expert Guide to Hepatitis B.
I hope this answer was helpful to you and your fiancée, and I wish you both a happy and healthy future together.
Dr. Lesondak is a Community Psychologist with the Chicago Department of Public Health. Her areas of expertise include STDs, HIV, preventive care, public health and community planning, as well as human sexuality and women’s health. Dr. Lesondak was educated at Georgia University in Atlanta.