Hepatitis B guide

Definition

What is Hepatitis B?

Hepatitis B is a sexually transmitted disease that inflames the liver, and it's a global health problem … it's estimated that there are more than 350 million carriers of the hepatitis B virus (HBV) worldwide, and more than 600,000 people die from HBV-related liver disease every year.

According to the Centers for Disease Control and Prevention (CDC), approximately 1.4 million people in the United States are chronically infected and there are some 43,000 new cases of HBV infection every year.

Hepatitis B is easily transmitted through unprotected vaginal, anal or oral sex when the blood, saliva, semen or vaginal secretions of an infected partner enter the body. Although rare, you can also get hepatitis B infection from blood transfusions, or by sharing needles, syringes, razorblades or toothbrushes that are contaminated. Additionally, infected mothers run the risk of passing hepatitis B to their babies during childbirth.

While hepatitis B is not curable, there is a vaccine to prevent the disease which is routinely given to children. The good news is that most adults infected with the virus fully recover with antiviral medications … sometimes, it even clears out of the body without treatment. Chronic cases can result in severe liver damage (cirrhosis), liver cancer … even death. Learn more about the difference between acute (short-term) and chronic (long-term) hepatitis B infections.

The earlier hepatitis B is diagnosed, the more successfully it can be treated.

Reference

Risk

Hepatitis B risk factors

How do people get infected with hepatitis B?

Anyone can get hepatitis B … usually through sexual activity. The most common risk factors are:

  • A history of STDs, especially HIV
  • A history of unprotected sex
  • A new sexual partner
  • Multiple sexual partners
  • Men who have sex with men (MSM)
  • Healthcare workers exposed to blood
  • Hemophiliacs (people affected by a hereditary bleeding disorder)
  • Intravenous (IV) drug use and sharing needles

People who are from — or travel to — China, southeast Asia and sub-Saharan Africa are also at a higher risk for hepatitis B. If you have the virus, don't share needles, syringes, razorblades or toothbrushes. Use a latex condom every time you have vaginal or anal sex, and use a condom or dental dam if you have oral sex.

What are some ways that hepatitis B cannot be spread?

Hepatitis B cannot be passed through food, drinking from someone's water bottle, eating utensils, sneezing, kissing, holding hands or breastfeeding.

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Symptoms

Hepatitis B signs and symptoms

Hepatitis B is most often asymptomatic (no symptoms). Although the virus can be sexually transmitted, it damages the liver … so you won't see any signs on your genitals like a rash, and you won't necessarily feel any symptoms since the virus is acting internally. Within six months of exposure, however, the following symptoms may develop:

  • Flu-like symptoms, including fever and fatigue
  • Nausea or vomiting
  • Loss of appetite or weight loss
  • Abdominal pain
  • Joint pain
  • Dark urine or gray-colored bowel movements
  • Jaundice (yellowing of the skin and the whites of the eyes)

Symptoms of chronic (long-term) hepatitis B infection may not show up for decades, but can include all of the same symptoms listed above, along with abdominal swelling, testicular changes and other abnormalities. Even when no symptoms are present, hepatitis B is highly contagious and can be transmitted to others … that's why getting tested is so important.

Complications

Hepatitis B complications

What if hepatitis B is untreated?

Left undiagnosed and untreated, chronic (long-term) hepatitis B infection often develops into a serious illness that can lead to:

  • Scarring of the liver (cirrhosis)
  • Liver failure
  • Liver cancer
  • Blood vessel inflammation (vasculitis)
  • Increased susceptibility to hepatitis D infection

Hepatitis B and HIV

People who have hepatitis B and are HIV-positive are more likely to suffer from chronic hepatitis B complications. In fact, research shows that chronic hepatitis B infection affects approximately 10% of HIV-infected patients worldwide. To minimize your risk of becoming infected or spreading hepatitis B infection to others, get tested if you think you might have been exposed, and continue to use latex condoms … and if you use a needle to inject drugs, be sure it's sterile and don't share it with anyone else.

In general, someone who has one STD is at greater risk for infection with other STDs, including HIV. That's because STDs that cause ulcers, sores, or otherwise break the skin or mucous membranes make carriers more susceptible to infection … also, someone with one or more STDs may have a weakened immune system that makes them more vulnerable to other diseases.

Hepatitis B and pregnancy

Pregnant women with hepatitis B may transmit the virus to their babies at or before delivery. But if women are tested before their pregnancy — or early in their pregnancy — and treated with neonatal vaccination, the risk to their babies is significantly reduced.

If you're pregnant and concerned about hepatitis B, be sure to consult your regular doctor.

Testing

Hepatitis B Testing

How do I get tested for hepatitis B?

We make getting tested for hepatitis B simple. We offer the highly accurate and reliable Hepatitis B Surface Antigen (HBsAg) blood test that provides early detection of acute or chronic hepatitis B infections … typically within 6 to 10 weeks of exposure and sometimes sooner, often before symptoms appear. Best of all, the test is easy and safe (no undressing or swabbing required!).

What hepatitis B Test results mean

A positive hepatitis B Test result means that you may have an active hepatitis B infection. A negative hepatitis B Test result means that the virus was not detected in your blood. But because hepatitis B may not yet be detectable if you get tested too soon after possible exposure to the virus, you'll want to get tested again three months after exposure to confirm that you're negative … repeat testing is critical to ensure the most accurate diagnosis.

If you test positive, we're here to help. You'll have the opportunity to consult with a doctor on the phone right away. We'll answer your questions and help you determine the next steps based on your specific circumstances.

Note: As with HIV and hepatitis C, if you test positive for hepatitis B, you should not donate blood.

Understanding false-positive or false-negative test results

As with most medical tests, there's a slight chance (1-4%) that a positive test result indicates an infection when there isn't one (false-positive); or a test comes back negative, despite the presence of infection (false-negative). For example, a false-negative test result can happen if an infected person tests too early for an infection to be detected … that means it's possible to get a negative test result but still have an STD.

If you're concerned about the reliability of your test results for any reason (e.g., timing, or your sexual history, or your partner's sexual history), we recommend that you get re-tested three months after possible exposure to the virus to confirm your results … and to minimize the risk of being a carrier and potentially developing more serious symptoms down the road.

Learn more about "testing windows" — the recommended amount of time between potential exposure to an STD infection, and when screening is expected to identify the infection (or re-infection); for example, if you had unprotected sex last night and became infected with hepatitis B, the virus wouldn't necessarily show up right away … it can take up to three months to test positive.

Treatment

Hepatitis B treatment

Is there a cure or treatment for hepatitis B?

Yes. Once you've been tested and diagnosed with hepatitis B, it can be treated and managed by a liver or infectious disease specialist … but it can't be cured. The hepatitis B vaccine is the most effective protection against hepatitis B infection and related health complications … health professionals generally recommend the vaccine for newborns, children who have not been vaccinated and people of any age who are at risk for hepatitis B infection.

If you have hepatitis B, we recommend that you get vaccinated for hepatitis A as a precautionary measure (there is no vaccine for hepatitis C) … pneumonia, influenza and other routine vaccines are also recommended (including diptheria and tetanus).

If I know I've been exposed to hepatitis B, what should I do?

If you know you've recently been exposed to hepatitis B, call your doctor or go to the nearest Emergency Room right away … receiving an injection of hepatitis B immune globulin within 24 hours of exposure may prevent your developing the disease.

Acute hepatitis B

If you have an acute (short-term) hepatitis B infection, depending on the severity of your symptoms, no treatment may be necessary. Be sure to get plenty of rest, drink lots of fluids, eat a healthy diet, and avoid alcohol, sedatives and painkillers. You'll also need to be re-tested to confirm that the virus is inactive in your body … and you'll want to see a doctor for managing the infection and follow-up testing.

Chronic hepatitis B

If you've been diagnosed with chronic (long-term) hepatitis B infection, antiviral medications can slow the effects of liver damage … and if your liver is seriously damaged, getting a liver transplant may be an option.

Pregnancy and treatment

Hepatitis B should be closely managed before and during pregnancy to reduce the potential risks to your baby. Consult your regular doctor about the risks involved, and to identify a treatment that's best for you and your baby.

Concerned about Hepatitis B?

Find out if you should get tested today; peace of mind has never been easier. Questions about our process? See how our STD testing works.