Hepatitis B - Get the Facts

What You Need to Know

YOU CAN HAVE IT AND NOT KNOW IT

What is hepatitis B?

Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV). It can be prevented by a vaccine. HBV is about 100 times more infectious than HIV. 

Within 6 months of becoming infected, about 90 percent of adults will clear the virus on their own (acute hepatitis B) and develop lifelong protection against it. The remaining 10 percent of people who are infected are unable to clear the virus and will become chronic carriers (meaning they are chronically infected and infectious). Chronic hepatitis B infection is treatable.

It is estimated that between 0.7 and 0.9 percent of Canada’s population is chronically infected with HBV.  About five percent of people in Canada have had hepatitis B at some point in their lives (prior acute infection).  In 2008, the overall reported rate of acute hepatitis B infection in Canada was 0.74 (individuals infected) per 100,000 people living in Canada.

How is hepatitis B spread?

HBV is found in the blood and body fluids (semen, vaginal fluid and saliva) of an infected person. The virus is most commonly spread through: sexual contact with an infected person; sharing contaminated needles and other drug-using paraphernalia (e.g., straws, pipes, spoons and cookers); by sharing personal care articles such as razors, scissors, nail clippers or a toothbrush with an infected person; or from an infected mother to newborn infant at the time of birth. In countries where the infection is widespread and where standard precautions are not always practiced during medical or dental procedures, transmission of the virus is common.  The virus can also be transmitted in the workplace from exposure to an infected person’s blood or body fluids. Transmission through saliva not visibly contaminated with blood is uncommon. 

Hepatitis B is NOT spread by:

• coughing, sneezing;
• touching or shaking hands with an infected person;
• breastfeeding (unless the nipples are cracked and bleeding. Breastfeeding can be resumed when the nipples are healed);
• using toilet seats;
• hugging and dry kissing; or
• other casual contact.

What are the symptoms of hepatitis B?

Symptoms of HBV infection can include jaundice (yellowing of the skin and eyes), fatigue, loss of appetite, nausea, dark urine, pale stools, joint pain and pain in the stomach area.

About half of the people infected with HBV don’t have any symptoms – that’s why it’s important to take precautions against HBV, and to get tested if you think you might be infected.

Why do I need my liver?

It is important to keep your liver healthy because it plays a key role in your overall health.  It helps digest food and stores vitamins and minerals.  It acts as a filter for chemicals and other substances that enter your body.  It also helps to produce blood and proteins that keep your body working.

Why is hepatitis B a health concern?

Because the time between initial contact with HBV and the onset of any symptoms ranges from two to six months and only about 50 percent of people ever develop symptoms, it is possible for people to spread the virus without even knowing they are infected.

People with a chronic HBV infection are at an ongoing risk of transmitting the virus to others and of developing serious health complications such as scarring of the liver (cirrhosis) or liver cancer.

How can I protect myself and others against HBV?

There is a safe and effective vaccine available to prevent you and others from getting hepatitis B. In Canada, all provinces and territories have free immunization programs for children and certain groups of adults.  

If you are pregnant and infected with hepatitis B, it is important for you to know that your infant is at a high risk of becoming a chronic carrier. In Canada, it is recommended that infants born to infected mothers receive a special injection immediately after birth, as well as, the first dose of vaccine within 12 hours of birth to help prevent infection.

In addition to hepatitis B immunization, these are precautions that may also help you to avoid infection with HBV and other sexually transmitted and blood-borne infections (STBBI):

• Never share needles/syringes, spoons, drug solutions, water, filters, cookers, pipes, straws used for snorting drugs, and other drug related equipment;
• Don’t share personal items like nail clippers, razors, or toothbrushes;
• If you are getting a tattoo, body piercing or acupuncture done, check things out first. NEVER allow anyone to use homemade equipment on you or re-use equipment, including needles, ink or jewellery. Make sure only fresh, single-use, disposable needles are used and that all other equipment is disinfected and sterile;
• If you are likely to be in contact with blood or other bodily fluids in your work ( e.g., nurse or lab technician), take appropriate precautions, such as wearing latex gloves;
• Practice safer sex. Use condoms and/or dental dams to reduce the risk of acquiring STBBIs including HBV; and
• Be especially careful when travelling abroad in countries where HBV is widespread.

How can I find out if I have hepatitis B?

If you think you may be at risk for hepatitis B, consult your health care provider. A blood test can determine if you have been exposed to the virus.

What if I have hepatitis B?

If you are newly infected, your health care provider will need to perform further blood tests over time to see if you clear the virus. If you clear the virus, this means you had an acute infection. Once the virus has cleared, you will no longer be infected and will not be able to transmit the virus to others. Until your health care provider tells you whether you have cleared the virus, you are still infectious and are still able to transmit the virus to others.

If you don’t clear the virus over time, this means you have a chronic HBV infection.
Various medications are available to treat chronic hepatitis B and to help protect against liver damage. Your health care provider may also advise vaccination against hepatitis A to further lessen the likelihood of liver damage.

People with hepatitis B (acute or chronic) should avoid or limit alcohol consumption because it can further impair your liver and cause more rapid progression of liver disease.

If you have either an acute or chronic infection, you should advise anyone who may have been exposed to your bodily fluids (e.g., sexual partners, people you live with, and health care workers). These people should consult a health care provider right away as there are ways to prevent them from getting the infection.

If you have acute or chronic hepatitis B, you may infect others. To prevent spreading the virus:

• Never donate blood, tissue, organs or semen;
• Use condoms/dental dams to limit transmission of HBV as well as other STBBIs. The risk of sexual transmission is high;
• Advise your sexual partner(s) to be assessed for HBV immunity and immunization;
• Advise individuals living in your household to be assessed for HBV immunity and immunization;
• Never share materials used to prepare, inject or inhale drugs (e.g., needles/syringes, spoons, drug solutions, water, filters, cookers, pipes, straws);
• Never share sharp instruments/personal care items (e.g., toothbrushes, scissors, razors, or nail clippers) with others;
• If you are getting a tattoo or planning to have body piercing or acupuncture done, ensure that only sterile equipment is used;
• If you are pregnant, inform your health care provider so that all the necessary precautions for the baby are taken at or soon after birth; and
• Cover open wounds or sores.

REMEMBER

Hepatitis B is a vaccine-preventable disease.

Chronic hepatitis B is treatable. If you think you are at risk of infection, it is important to find out if you have HBV so that you can take the necessary steps to protect yourself and others as well as to obtain proper medical attention to manage your infection.