Hepatitis B | Pokenga ate

Key points about hepatitis B

  • Hepatitis B virus is spread through contact with the blood or other body fluids of an infected person.
  • The virus attacks your liver cells causing either short-term (acute) or long-term (chronic) hepatitis.
  • Acute hepatitis infection can make you feel unwell, but most people recover fully.
  • Chronic hepatitis B is when you still have it more than 6 months after your first blood test result. 
  • One of the best ways to avoid getting hepatitis B is to get vaccinated. Hep B is part of the childhood immunisation schedule. Older children and adults can also be vaccinated. 
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  • Hepatitis B virus is spread through contact with the blood or other body fluids of an infected person. The virus attacks your liver cells causing either short-term (acute) or long-term (chronic) hepatitis.
  • Acute hepatitis infection can make you feel unwell, but most people recover fully. It is important that you protect others from becoming infected. 
  • A simple blood test can establish whether you still have the hepatitis B virus in your blood or whether you have been able to successfully get rid of the virus. 
  • Chronic hepatitis B is when you test positive for the hepatitis B virus for more than 6 months after your first blood test result. This means that your immune system was not able to get rid of the hepatitis B virus and it still remains in your blood and liver. The symptoms of chronic hepatitis B are less noticeable. Treatment is focused on preventing long-term liver damage. Read more about chronic hepatitis B.
  • One of the most effective ways to avoid getting hepatitis B is to get the hepatitis B vaccine. This is part of the childhood immunisation schedule. Older children and adults can also be vaccinated. 

Video: Hepatitis

(external link)

(Immunisation Advisory Centre, NZ, 2017)

Hepatitis B is spread through contact with the blood or bodily fluids (eg, saliva and semen) of an infected person. 

Ways in which hepatitis B is spread 

  • Through unprotected sex including anal or oral sex.
  • Through tattooing or body piercing with unsterile equipment.
  • By sharing injection equipment, toothbrushes or razors.
  • Through a needle stick injury.
  • From mother to child during childbirth – read more about hepatitis B and pregnancy.

Ways hepatitis B can be spread

Image credit: 123rf


Hepatitis B is not usually spread through:

  • sharing food and utensils
  • kissing on the mouth
  • coughing or sneezing everyday contact, eg, in a school or workplace
  • playing contact sports, as long as wounds are covered and you remove yourself from play to attend to any injuries involving blood
  • breast milk
  • urine, poos or vomit, unless these contain blood.

Symptoms can appear anywhere from 6 weeks to 6 months after becoming infected, often after 2 to 3 months. Some people don't have any symptoms, but others can have symptoms including:

  • feeling sick or vomiting
  • lack of appetite
  • flu-like symptoms, eg, tiredness, general aches and pains, fever or muscle aches
  • stomach pain
  • pale, clay-coloured poos and or dark coloured urine
  • yellowing of your skin and eyes (known as jaundice).

Anyone can get hepatitis B, but those most at risk are:

  • babies born to mothers who have hepatitis B
  • people with multiple sex partners
  • men who have sex with men
  • people with a sexually transmitted infection (STI)
  • people who inject illegal drugs
  • people who use unsterile equipment for tattooing
  • people who live with someone who has hepatitis B
  • healthcare and public safety workers exposed to blood at work
  • people having kidney dialysis
  • travellers to regions with intermediate or high rates of hepatitis B
  • people who participate in contact sports where there's a high risk of bleeding injury
  • people 25 years of age or over who are of Māori, Pacific Peoples or Asian ethnicity
  • people born in Asia or the Pacific Islands.


Children are at greater risk of chronic hepatitis

Most people with chronic hepatitis B infection were infected as babies (from their mother at delivery) or as young children (from playing with infected children or close contact with an infected family member).

Children who have the disease usually develop a mild illness, but sometimes they'll have no symptoms. They are more likely to continue to carry the virus (called hepatitis B positive). Many years later, they may develop liver damage and cancer. For this reason, all infected children require long-term follow-up.

When adults are infected, they usually become sick with acute hepatitis (jaundice, abdominal pain and vomiting), but are at much less risk of developing chronic hepatitis.

Hepatitis B can be diagnosed with blood tests to detect the presence of the hepatitis B virus or antibodies to the virus. During the early stages of acute hepatitis B blood tests may show changes in your liver function.

If you're at higher risk of getting hepatitis B, get tested. If you are pregnant, you should also get tested as part of antenatal blood testing. Read more about hepatitis B and pregnancy

If you are in one of these high-risk groups, get tested for hepatitis.  You are at high risk if:

  • you're Māori, Pacific Peoples, South East Asian or Chinese ethnicity
  • you're 30 years of age or older
  • you're not sure if you were vaccinated against hepatitis B as a child
  • you were born in a country with high rates of hepatitis B or travelling to these countries, eg, the Pacific Islands, China, South East Asia, Middle East and Africa
  • your mother or a close family or household member has hepatitis B
  • you’ve had unprotected sex with an HBV-infected person
  • you're a current injecting drug user or you injected drugs in the past
  • you’ve had tattoo, piercing or other cosmetic procedures using unsterile equipment in locations with few safety standards, eg, in prison
  • you engage in higher risk sexual activity (eg, sex work, men who have sex with men, unprotected sex while travelling in a country with high Hepatitis B prevalence)
  • you’ve come into contact with blood, through sports, assault, needle stick injury, etc.

 

If you test positive for hepatitis B infection, you must take steps to reduce the risk to your sexual partners and others in your household. It’s a good idea for sexual partners and people living in your household to also be tested.

Most people with an acute hepatitis B infection manage with support from their healthcare provider. 

Some people with a chronic hepatitis B infection may need treatment with antiviral medication. These medicines don't get rid of the virus but they reduce how much the virus multiplies. They help prevent complications (eg, cirrhosis, liver failure and liver cancer) and also help prevent you passing on the infection to others. Read more about chronic hepatitis B infection.

Apps reviewed by Healthify

You may find it useful to look at some Symptom checkers and Symptom trackers.

Vaccination

One of the most effective ways to avoid getting hepatitis B is to get vaccinated.

  • The hepatitis B vaccine is part of the childhood immunisation schedule in Aotearoa New Zealand and consists of 3 injections over 3 to 6 months.
  • All babies should be vaccinated.
  • Older children, adults and travellers can also be vaccinated. Ask your healthcare provider what is right for you.

Read more about the hepatitis B vaccine


Other ways to reduce your risk of getting hepatitis B

  • Never share drug equipment with other drug users. This includes needles, syringes, spoons and filters as well as bank notes or straws to snort cocaine.
  • Don't share personal items, eg, toothbrushes and razors.
  • Use a condom during sex, including anal and oral sex.
  • Have a sexually transmitted infection (STI) check before you have unprotected sex with a new partner.
  • Limit how much alcohol you drink. Read more about safer alcohol limits.
  • Make sure any blood spills are cleaned up properly – the virus can live on objects for 7 days or more. Even if you don’t see any blood, the virus could still be there.

Protect new sexual partners

If you're a carrier for hepatitis B and have a new sexual partner then they will be at risk of catching it from you. They should be checked for immunity against hepatitis B. It's likely they're protected if they're under 25 years of age as they should be protected by vaccination at birth.

If your partner isn't immune, then they can receive a free hepatitis B vaccination which will protect them from getting acute hepatitis B. After they've finished the course of vaccines (3 over 3 to 6 months), they should be tested for protective immunity against hepatitis B. Until then, you and your partner should use condoms to prevent hepatitis B infection.

Where do I go for a sexual health check-up?

The Hepatitis Foundation of NZ(external link) provides a follow-up programme for people with hepatitis B. Their community nurses help follow-up people in the community, through home visits, to provide education and support to individuals and families. It's a free programme.

Hepatitis B(external link) The Hepatitis Foundation NZ
Hepatitis B(external link) The Immunisation Advisory Centre, NZ
Hepatitis B(external link) Healthy Sex, NZ

Apps

Symptom checkers
Symptom trackers

Resources

Hepatitis B [PDF, 565 KB] Ministry of Health, NZ
Childhood immunisation booklet(external link) HealthEd, NZ
Hepatitis B and C(external link) HealthEd, NZ
Hepatitis B – personal record(external link) Health New Zealand | Te Whatu Ora, 2020
Looking after yourself with hepatitis The Hepatitis Foundation of New Zealand

References

  1. Hepatitis B – treatments now available for primary care(external link) BPAC, NZ, 2021
  2. Hepatitis B(external link) Communicable Disease Control Manual Health New Zealand | Te Whatu Ora, NZ, 2012

Brochures

hep b

Hepatitis B

Ministry of Health, NZ, 2012

Looking after yourself with hepatitis
The Hepatitis Foundation of New Zealand

hepatitis b and c

Hepatitis B and C

Department of Corrections and Ministry of Health, NZ, 2019

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Yini Ye and Rachel Li, Clinical Nurse Specialists, Middlemore Hospital

Last reviewed: