If you have had unprotected sex or are worried about possible infection with hepatitis B or other STIs, get tested as soon as possible – even if you have no symptoms.

What is Hepatitis B?

Hepatitis B – Hep. B or HVB – is a disease caused by a virus that belongs to a group of liver viruses that cause inflammation of the liver – when your liver is swollen and painful.

Is Hepatitis B a serious condition?

Hepatitis B can be serious and, without proper treatment and care, can cause liver disease and liver cancer, leading to death.

How can you get Hepatitis B?

Hepatitis B is very easily transmitted and you can get it in the following situations:

  • if you have unprotected sex (sex without a condom or dental dam), vaginal, anal and oral sex with someone who has hepatitis B (even if they have no symptoms).
  • if you use sex toys that are not washed or covered with a new condom.
  • if you are fingering, rimming or fisting – exploring your partner’s anus with your fingers, mouth or tongue; touching used condoms and sex toys that have been in someone else’s anus.
  • if you use needles and syringes together, contaminated during drug use.
  • if you get tattoos or piercings with unsterilized instruments or through unsterilized medical/dental equipment (rarely, the virus can be transmitted by sharing a towel, razor blades or toothbrush if there is infected blood on them).

Hepatitis B, HIV and sexual health

  • Having an STI, including hepatitis B, increases the risk of getting HIV. This is because most STIs cause lesions that make it easier for HIV to enter the body.
  • Because they are transmitted in similar ways, some people have both viruses, known as co-infection.
  • People with both viruses are more likely to develop chronic hepatitis B, and their livers can deteriorate more quickly.
  • If you live with HIV and have hepatitis B, your viral load may be higher because your immune system is weaker. This will make you more likely to transmit HIV if you have sex without a condom.
  • If you are living with HIV, your doctor should do regular hepatitis B tests and check your liver regularly.
  • If you take antiretrovirals, it’s important to talk to your doctor about how your hepatitis B treatment might interact with your HIV drugs.

Note – if you are living with HIV or have an increased risk of HIV infection, for example if you are a man who has sex with men, work in commercial sex work or use drugs, ask your doctor if you need to be vaccinated against hepatitis B.

How do I protect myself against hepatitis B?

  • Practice safe sex.
    • Find out the status of any sexual partner.
    • use a new condom (male or female) or a dental dam every time you have anal, vaginal or oral sex.
    • use a new dental dam or latex gloves for rimming and fingering; use latex gloves for fisting.
    • cover sex toys with a new condom and wash them after use.
  • Never share needles, syringes or other items that can be contaminated with blood, such as razors, toothbrushes and manicure tools.
  • Get tattoos, piercings or acupuncture in a professional setting and make sure new and sterile needles are used.
  • Get vaccinated against hepatitis B if you are in one of the high-risk groups (if you are a man who has sex with men, if you inject drugs, if you are a commercial sex worker, if you change partners frequently, if you come into contact with people who have chronic hepatitis B or if your job exposes you to the virus, for example if you are a nurse). This immunization is also recommended for people living with HIV.

Note – apart from condoms, other types of contraception (such as contraceptive pills) or PrEP do not protect against sexually transmitted infections.

What are the symptoms of hepatitis B?

Many people with hepatitis B have no symptoms. If symptoms do occur, they will last up to three months and you may not notice them until two or three months after infection. There are two stages of infection: acute and chronic.

Acute (or short-term) symptoms include:

  • flu-like symptoms, including fatigue, fever and aches and pains
  • feeling nauseous
  • weight loss/lack of appetite
  • diarrhea
  • tummy (abdominal) pain
  • jaundice, i.e. yellowing of the skin and whites of the eyes
  • dark urine (pee)
  • light-colored feces (poo).

For people who can’t fight infection (for example, babies, young children and people with weakened immune systems due to HIV), the virus can become chronic. This happens when people are at higher risk of liver failure, liver disease and liver cancer, but may not be aware of the dangers, as symptoms can last for years before the illness becomes very serious.

Can I get tested for Hepatitis B?

Yes – a simple blood test will show if you have the virus. You can also have further tests to see if your liver is damaged.

If you have hepatitis B, you should be tested for other STIs. It’s important to let your recent sexual partners know so they can get tested and treated. Many people who have hepatitis B don’t notice anything, and by telling them, you can help stop the virus from spreading; it can also prevent you from getting infected again.

How is Hepatitis B treated?

There is no specific treatment for acute hepatitis B, and most people recover within one to two months. You can usually manage symptoms at home with painkillers if necessary. Your doctor should advise you to have regular blood tests and physical check-ups. Most people recover fully from acute hepatitis B.

If you develop chronic hepatitis B, you will be given treatment to reduce the risk of permanent liver damage and liver cancer. Treatment does not cure chronic hepatitis B and most people who start treatment have to continue it for life.

Whether or not you have symptoms, don’t have sex until you get your doctor’s consent.

Once you’ve had acute hepatitis B, you become immune – which means you can’t get it again, but you can get other types, such as hepatitis A or C.

Complications of Hepatitis B

As with most STIs, hepatitis B puts you at risk of getting other STIs, including HIV.

Without treatment, chronic hepatitis B can cause scarring of the liver (cirrhosis), which can cause the liver to stop working properly; a small number of people with cirrhosis develop liver cancer; and these complications can lead to death. Apart from a liver transplant, there is no cure for cirrhosis. However, treatments can help relieve some of the symptoms.