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Hepatitis B – Basics

What is Hepatitis B?

Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV). It causes inflammation of the liver. Hepatitis B is usually transmitted through contact with blood, cum, vaginal fluids, spit, or from mother to baby. It is many times more infectious than HIV.

Can I get rid of hepatitis B?

The vast majority of people (more than 90%) get over their symptoms, suffer no lasting damage and stop being infectious. After you have cleared the infection you are immune to hepatitis B and can not get it again, however a minority (1% to 10%) [2] of older children and adults won't clear the hepatitis B virus and become chronically infected. People with chronic hepatitis B are sometimes known as ‘carriers’.

Whether a person clears the infection or becomes chronically infected with hepatitis B depends mainly on their age: 90% of newborn babies, 20-50% of children aged one to five years, and 1-10% of older children and adults, become chronically infected. [2]

People with chronic hepatitis B are usually infectious for life and while some people will have health problems, others will not. After many years, chronic hepatitis B infection can result in complications such as liver cancer or cirrhosis of the liver (liver scarring resulting in reduced function).

People who are 'e' antigen positive (HBe Ag+) are more infectious than others. Your doctor will tell you if this is the case.

[2] (NSW Health, Communicable Diseases Factsheet, Hepatitis B, pp1, 2006)

What are the symptoms?

Many people with hepatitis B experience no symptoms. When symptoms are present they can include:

Fever
Headaches
Feeling exhausted
Loss of appetite
Nausea, vomiting
Pain in the stomach
Itchy skin
Joint pains and muscle aches
Feeling generally unwell.

Some people may become jaundiced:

The whites of the eyes and skin turn yellow
Faeces goes a pale colour
Urine is dark-coloured.

How is hepatitis B diagnosed?

Hepatitis B is diagnosed by blood tests performed by your doctor.

A specific blood test indicates active hepatitis B (positive hepatitis B 'surface antigen')
Another test indicates how infectious you are. (A positive hepatitis B 'e' antigen indicates a high level of infectiousness.)
An antibody test shows if you have been exposed to hepatitis B at some point in time and are now immune
Liver function tests can show if any damage has been done to your liver.

What about complementary therapies?

People with hepatitis may consider using complementary therapies, either as a treatment for their liver, or to help relieve symptoms and side effects from medication prescribed for HIV or hepatitis B. It is important to be cautious about the use of complementary and herbal treatments which can involve risks. Always inform your HIV/hepatitis doctor and pharmacist about any other prescribed or herbal treatment you may be taking.

There is limited evidence from clinical trials that demonstrate the efficiency of complementary therapies and alternative treatments in relation to hepatitis B. Some popular herbal treatments can have a negative impact in the way HIV medication works. Remember to let your doctor know before taking any complementary treatment.

If you do seek treatment from a complementary therapist you are advised to:

Make sure the therapist has experience working with hepatitis and HIV
Ensure they are properly qualified and belong to a recognised professional organisation
Ask how much the treatment will cost
Ask how they have measured the health outcomes of their therapy
Find doctors and complementary health practitioners who will work together.

What about liver transplants?

Liver transplants might be necessary in extreme circumstances for some people with HIV and hepatitis co-infection. An increasing number have been performed on people co-infected with HIV and hepatitis B or C. They are only carried out when other treatments have failed.

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