What is Hepatitis B?
Hepatitis B is a virus carried in your blood and body fluids which infects and potentially can damage your liver. A virus is a particle that needs to get inside living cells in order to replicate. The Hepatitis B virus infects the cells in your liver resulting in your liver becoming inflamed, tender and scarred.
Hepatitis means inflammation of the liver, which can be caused by a number of things like viruses, drinking too much alcohol, fatty deposits in the liver or a side effect of some drugs and chemicals. Hepatitis B is classed as a blood borne virus that lives in your liver and moves around your body in your blood. It is spread by blood-to-blood contact; Hepatitis B is highly infectious. Hepatitis B can also be present in your bodily fluids such as saliva, semen and vaginal fluid.
Hepatitis B is the most widespread worldwide virus it is common in Southeast Asia, the Indian subcontinent, the Middle and Far East, Southern Europe and Africa.
Your blood is where the highest amount of Hepatitis B is present; a tiny amount of blood from someone infected with the virus can pass on the infection to someone through an open wound, a cut or scratch, or from a contaminated needle. Hepatitis B can survive outside of the body for up to one week meaning objects and surfaces contaminated with dried blood also pose a risk if not cleaned appropriately. Hepatitis B can also be passed on from mother to baby, all pregnant women in the UK are offered the option to be screened for Hepatitis B as part of their antenatal appointments. Transmission to your baby does not occur in the uterus however it can be transmitted to the baby during delivery as the baby is exposed to its mother’s blood in the birth canal.
Sexually active individuals who do not practice safer sex have a high risk of being infected with Hepatitis B. Hepatitis B can be transmitted by having penetrative, anal or oral sex with an infected person if a condom or dental dam (a protective measure for oral sex) is not used.
Injecting drugs including steroids, and or sharing needles or drug paraphernalia can increase your risk of contracting Hepatitis B.
Traces of Hepatitis B can be found in sweat, tears, breast milk, and urine but are very low risk of transmission. Hepatitis B can also be present in faeces (stool) and vomit however unless these bodily fluids are visibly contaminated with blood transmission is very low. Hepatitis B can also be transmitted during travel, sharing personal items like razors, hair clippers, toothbrushes they all pose various levels of risk which will be discussed at your clinic appointment. Please raise any questions regarding your concerns regarding transmission, alternatively please review below web sites for up-to-date information.
If you are diagnosed with Hepatitis B, vaccination against Hepatitis A is recommended as this can be more serious in people with existing liver conditions. Please discuss this with your GP, consultant or liver nurse specialist.
Please review www.britishlivertrust.org.uk or www.livernorth.org.uk or if you require any further information on how Hepatitis B is transmitted.
Will I experience any symptoms?
When the virus enters your body, you may experience no symptoms for up to six months (known as the incubation period). Many people with Hepatitis B may never develop any symptoms and not know they are infected and could pass the virus on to other people without realising. Hepatitis B can cause an acute or a chronic illness. An acute illness is a sudden illness that lasts for a short period of time (usually less than six months). A chronic illness is one that lasts longer than six months and could be possibly for the rest of your life, symptoms can come and go.
Some people only experience mild symptoms which include:
- Tiredness
- General aches and pains
- Fever
- Loss of appetite
- Feeling sick
- Stomach ache
- Some people are unable to tolerate alcohol or cigarettes
More severe symptoms might include:
- Diarrhoea
- Bowel motions may become pale looking
- Urine may turn really dark
- Jaundice (yellowing of the skin and or eyes)
How is Hepatitis B diagnosed?
Hepatitis B is detected by a blood test that looks for antibodies produced by your body’s immune system to fight the virus. Receiving the blood test result can take a little while so it is very important if you think you have been exposed to Hepatitis B that you take precautions not to transmit the virus to anyone else.
Alongside blood tests the clinical team will want to assess if you have any liver damage so will save bloods (liver function tests), including bloods to search for other infections like Hepatitis A or C. They will also request an ultrasound scan to determine the overall health of your liver, alongside this you will have a fibro scan. This is a painless non – invasive procedure similar to an ultrasound scan that records the extent of scarring to your liver that you may or may not have.
Treatments have not been included within this information leaflet due to the ongoing changes and differences between treatments. When you see or speak to a consultant or liver nurse specialist, they will discuss with you if you require treatment or if you just require yearly surveillance to ensure your Hepatitis B (if classified as chronic) remains stable and the virus is not causing any damage to your liver.
What are the benefits of the treatment?
Treatment for Hepatitis B depends on how long you have had the virus. Also, not everyone will require treatment. If you have low levels of virus in your blood, and little sign of liver damage it is very likely that regular monitoring will be recommended, and treatment will only be commenced if there are signs of disease progression. The time frame before commencing treatment will vary with each person, it may be several years, and once treatment is started it may need to continue long term.
During the acute phase of Hepatitis B most people do not require treatment, for the majority of people the symptoms resolve, and the person has cleared the infection usually within six months, meaning you are no longer infected, but your blood will always show you have Hepatitis B antibodies.
People who have been classified as having chronic Hepatitis B require treatment to stop or reduce viral activity (by way of viral replication) causing damage to your liver. If you do require treatment all of your blood and scan results will be reviewed, and you will commence treatment appropriate for you based on those results.
It is very important to remember that if you have started treatment, you must complete the full course as directed as stopping treatment for even a short period of time can lead to drug resistance (causing the tablets not to work).
Side effects are different from person to person, depending on which treatment they are taking, but you must contact your specialist nurse or GP if you are experiencing side effects before stopping the treatment. Common side effects that you may experience are flu like symptoms, headaches, fever, fatigue and general aches and pains. You may experience other side effects not highlighted depending on which treatment you are taking.
Looking after yourself
Alcohol
Alcohol can be consumed but you must adhere to safe alcohol levels of 14 units or less per week. If you have liver cirrhosis or advanced scarring of your liver, we advise abstinence from alcohol.
Diet and Exercise
There are no specific dietary or exercise requirements but maintaining a well-balanced healthy diet and adhering to regular exercise is essential to overall wellbeing and is recommended. To eat healthily you need to get the right balance between different foods. For most people, a well-balanced diet is one that is low in fat, sugar and salt, and high in fibre. Your diet should also contain enough protein and a wide range of vitamins and minerals. It is important to remember that your body’s nutritional needs may vary depending on the type and severity of your condition. Particularly, if you are unwell and losing weight you may need to vary your diet.
Will I need follow up appointments/telephone consultations?
Yes, you will be followed up by either the doctor or nurse specialist every six months, bloods will be saved and every year you will attend for an abdominal ultrasound scan. You may be required to see or talk to the nurses earlier than six months if you are receiving treatment.
If I have any questions, who should I contact for advice?
You could contact one of the liver nurses via our hospital switchboard telephone 0191 4820000 Mon to Fri 8:30 am until 4:30 pm, alternatively you could speak to your consultant’s secretary or seek the advice of your GP. Out of hours if you need to talk to someone about your appointment or any other issue which could not wait until the next working day during office hours you could speak to the senior nurse by contacting the hospital switchboard and requesting you speak to the senior nurse.
How to contact us?
If you need more advice or would just like to have a chat about your condition, please contact the liver nursing team via the hospital switchboard on Tel 0191 482 0000, or ring them on their direct help line 0191 4453935.