Hepatitis B (HBV) is a vaccine preventable infection which can cause chronic liver disease and is one of the leading causes of liver cancer. In the UK, the most common way for HBV to be spread is by contact with blood or other body fluids of an infected person, most often through unprotected sex or sharing of injecting equipment.
About 95-97% of adults who are infected with HBV will have a short lived illness where symptoms are feeling generally unwell, nausea, abdominal pain and inflammation of the liver before completely recovering. Usually very young children, older adults and about 3-5% of adults who are infected with HBV will become chronic carriers of infection.
About 20% of chronic carriers (as high as 90% in infants infected in the first year of life) will develop progressive liver disease. People with scarring of the liver caused by HBV infection have around a 1 in 20 chance of developing liver cancer every year.
Pregnant women in the UK are screened for HBV and in August 2017, the hepatitis B vaccine was included in the UK childhood immunisation programme. The vaccine is also offered to those at an increased risk of infection including; injecting drug users and their families, patients with chronic kidney or liver disease, prisoners, people travelling to countries where HBV is more common and people with an occupational risk such as healthcare workers and prison staff.
Hepatitis B can be spread by:
- A mother to a baby
- Sharing injecting equipment
- Having sex without a condom
- Tattoos, body piercings and medical treatment with equipment that is not sterile
- Blood transfusions abroad (all blood products in the UK are screened for HBV)
- Needlestick injuries
- Contact with blood or bodily fluids (open wounds, scratching, biting)
The people most at risk are
- People born, living in or travelling to countries where HBV is more common (Sub-Saharan Africa, East and S.East Asia, the Pacific Islands, parts of South America, S.Eastern and S.Central Europe, the Middle East, the Indian subcontinent)
- Babies born to mothers who have HBV infection
- People who inject drugs
- People who have unprotected sex (especially people who have multiple sexual partners, sexual partners from high-risk areas, men who have sex with men, and commercial sex workers)
- Family members and close contacts of a person with chronic HBV infection
Treatment and Prevention
You should see your GP as soon as possible if you think you have been exposed to hepatitis B. Treatment can be given up to 1 week after exposure but is most effective if given within 48 hours.
There are several medications which can be given to help control the virus and prevent it from damaging your liver.
The hepatitis B vaccine is offered to all babies born in the UK at 8, 12 and 16 weeks of age and anyone thought to be at risk of infection or complications. Full protection involves having 3 or 4 injections of the vaccine which is thought to provide protection for 20-30 years. People at high risk of exposure may be offered a booster.
- Healthcare workers should be offered a single booster dose 5 years after the initial course.
- Patients with kidney failure should have annual blood tests to check immunity and be offered a booster if required.
- Anyone who has a suspected or confirmed significant exposure to HBV.