About 90% of adults who become infected with hepatitis B completely recover from the infection after approximately six months. During this time of acute infection, people can either be symptom free or get sick with signs and symptoms such as:

• jaundice (i.e., skin and eyes turn yellow)
• pale stools
• dark urine
• fatigue
• tenderness in the upper right side of the stomach area
• loss of appetite

About 8% to 10% of adults who acquire hepatitis B remain chronically infected (i.e., they do not clear the virus on their own). Individuals who are chronically infected can remain symptom free for years. However, the ongoing liver inflammation associated with chronic hepatitis B can put one at increased risk for complications such as cirrhosis (i.e. severe liver scarring) or liver cancer. 

Whether you have signs of illness or not, if you have the virus in your body you can pass it on to others.

• sex with an infected person
• sharing contaminated needles to inject drugs
• an infected mother to her newborn during birth
• the hepatitis B infection can be prevented in almost all newborns by giving the baby hepatitis B immune globulin and hepatitis B vaccine at birth

Hepatitis B is NOT spread by:

• sneezing
• coughing
• hugging
• using the same dishes or cutlery as an infected person
  

Chronic hepatitis B can eventually lead to serious liver diseases such as cirrhosis and liver cancer. Having had hepatitis B infection as an infant or child gives you a greater chance of developing these complications as an adult. 

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. 

A person chronically infected with hepatitis B is also susceptible to being infected with another viral hepatitis: hepatitis D. You cannot become infected with hepatitis D unless you're already infected with hepatitis B.

A blood test is necessary to diagnose hepatitis B. There are several tests used in the detection and management of hepatitis B. Initially the three blood tests that will be performed are:

• Hepatitis B surface antigen (HBsAg): determines if you are infected (acute or chronic infection) 
• Antibody to HBsAg (Anti-HBs): determines if you have immunity to HBV either through a past cleared infection or hepatitis B vaccination
• Antibody to core antigen (Anti-HBc): determines if you have been previously infected with HBV (not present after HBV immunization)

Note: These are not the only tests for hepatitis B. There are other tests that may be performed for monitoring and treatment.

Fortunately, there is a vaccine that provides protection against hepatitis B. The vaccine is highly recommended as it is 95 percent effective in preventing hepatitis B infection and its chronic consequences. 

The majority of younger British Columbians are now immune to hepatitis B due to the addition of the universal Grade 6 immunization program that has been in effect since 1992 and the universal infant vaccine program since 2001.  

If you have not received the vaccine and are susceptible to infection, talk to your health care provider about getting vaccinated.

Treatment for chronic HBV

The treatments for hepatitis B can suppress the infection but not cure it. There are drugs that interfere with viral replication or improve the immune system’s response to the infection. The goal of treatment is to reduce the risk of serious complications such as cirrhosis and liver cancer. 

There are several new therapies in development which are expected to improve the management of hepatitis B in the future. A discussion with a healthcare provider specializing in viral hepatitis is necessary to inform you of the various therapeutic options.

If you have think you may have recently been exposed to the hepatitis B virus, contact your public health unit or doctor as soon as possible. You may be eligible for hepatitis B vaccine and they may be able to offer you a product that offers additional protection against the hepatitis B virus.

Help4HepBC, a free helpline, was launched by BC Hepatitis Network. Callers can talk one-to-one with a trained staff person.

The BC Hepatitis Network can connect you with local support groups in your area.