Hepatitis B is a serious liver disease that can be contracted by sexual contact and can result in serious consequences. Many individuals have this disease and have no symptoms but can still spread the disease too others. There is a vaccine available to prevent Hepatitis B and many persons in Anguilla who are at risk of developing this disease have received this vaccine.

How can you get Hepatitis B?
Hepatitis B virus causes Hepatitis B infection. This virus is very contagious and can infect individuals of all ages.
The Hepatitis B virus is transmitted through contact with the blood and body fluids of someone who is infected. You’re especially at risk if you are an intravenous (IV) drug user who shares needles or other paraphernalia, have unprotected sexual contact with an infected partner, or were born in or travel to parts of the world where Hepatitis B is widespread. In addition, women with HBV can pass the infection to their babies during childbirth.

Who are at risk for getting Hepatitis B?
Anyone can get Hepatitis B, but some individuals are more at risk than others.
Sexually active persons who have multiple partners, and persons who have one sexual partner, but whose partner has other partners, are at an increased risk of developing Hepatitis B. Other at risk groups include:
• Persons who are working in jobs that expose them to human blood or blood fluids
• People living with others who are chronic carriers of the Hepatitis B virus
• Adolescents
• People who practice tattooing or body piercing
• People who use street drugs

What are the signs and symptoms of Hepatitis B infection?
Many individuals with Hepatitis B infection do not have any signs and symptoms. Most infants and children with Hepatitis B do not develop any signs or symptoms. In those individuals who develop symptoms they usually appear 12 weeks after they were infected with the virus and the symptoms may vary from being very mild to very severe and include the following:
 Loss of appetite
 Nausea and vomiting
 Weakness and fatigue
 Abdominal pain, especially around your liver
 Dark urine
 Yellowing of your skin and the whites of your eyes (jaundice)
 Joint pain
Hepatitis B can damage your liver — and spread to other people — even if you don’t have any signs and symptoms. That’s why it’s important to be tested if you think you’ve been exposed to Hepatitis B or if you engage in behaviour that puts you at risk.

How is Hepatitis B diagnosed?
Many people with Hepatitis B don’t have signs and symptoms. Doctors diagnose the disease on the basis of one or more blood tests and these include Hepatitis B surface antigen and antibody to Hepatitis B surface antigen tests. Your doctor will decide if further tests are needed to make the diagnosis.

What are some of the complications of Hepatitis B infection?
Having a chronic Hepatitis B infection (HBV) eventually may lead to serious liver diseases such as cirrhosis and liver cancer. Having had HBV infection as an infant or child gives you a greater chance of developing these illnesses as an adult.
In addition, Hepatitis B puts you at risk of acute liver failure — a condition in which all the vital functions of the liver shut down. When that occurs, a liver transplant is necessary to sustain life.
Anyone chronically infected with HBV is also susceptible to infection with another strain of viral hepatitis — Hepatitis D. Formerly known as delta virus, the Hepatitis D virus needs the outside coat of HBV in order to infect cells. You can’t become infected with Hepatitis D unless you’re already infected with HBV.

Treatment
There is no cure for Hepatitis B infection. If you know you’ve been exposed to the Hepatitis B virus, call your doctor immediately. Receiving an injection of Hepatitis B immune globulin within 24 hours of coming in contact with the virus may help protect you from developing Hepatitis B. You should also receive the first in a series of three shots of the Hepatitis B vaccine.

Once you’ve developed chronic Hepatitis B, few treatment options exist. In some cases — especially if you don’t have signs and symptoms or liver damage — your doctor may suggest monitoring, rather than treating, your condition. In other cases, your doctor may recommend treatment with antiviral medications. When liver damage is severe, liver transplantation may be the only option.

Prevention
A number of Hepatitis B vaccines are available. They have typically been given in a series of three immunizations at zero, one and six months, but some can also be given in an accelerated four-dose schedule. Another is given in two doses in adolescents ages 11 to 15. These vaccines provide more than 90 percent protection for both adults and children, and they generally protect against HBV for at least 23 years. You can’t get Hepatitis B from the vaccine.

Individuals can also decrease their chances of developing Hepatitis B infection by avoiding risky sexual behaviours. Individuals should know the Hepatitis B virus status of any sexual partner. Do not engage in unprotected sex unless you’re absolutely certain your partner isn’t infected with HBV, HIV or any other sexually transmitted disease.

High-risk individuals are encouraged to use a new latex or polyurethane condom every time they have sex. If you don’t know the health status of your partner, use a new latex condom every time you have sex. If you’re allergic to latex, use a plastic (polyurethane) condom.

If you’re pregnant, get tested. Knowing whether you’re infected with HBV can allow you and your doctor to take steps to protect your child.

Conclusion
Hepatitis B infection is a very contagious infective disease that is caused by the Hepatitis B virus. Safe and effective vaccines are now available to protect against this potentially serious disease. Individuals who have questions about this condition should consult with their doctor or health care provider.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

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