Hepatitis B | Pokenga ate

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.
  
  

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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, Pasifika 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 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.

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?

• Your healthcare provider.
• Sexual Wellbeing Aotearoa (find a Sexual Wellbeing Aotearoa clinic(external link)).
• Sexual health clinics have specialists who are experienced in the management and diagnosis of sexually transmitted infections. Each visit is confidential and the people there can help with testing your sexual partners or family members. For some people, the consultation may be free. Find a sexual health clinic.(external link)

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.