Hepatitis B

Hepatitis B is a liver infection caused by the hepatitis B virus. The infection can be prevented with vaccination. It is transmitted by sexual contact or blood contact. Many people who live with hepatitis B infection don't have symptoms. Without testing or treatment, the liver can become damaged and cause liver diseases.

Most people have no signs or symptoms of hepatitis B.  People who have hep B may have some or all of the following symptoms:

• Fatigue (feeling tired)
• Jaundice (yellowing of the skin and whites of the eyes)
• Dark urine, pale stools
• Abdominal pain, nausea, vomiting, poor appetite

Hepatitis B is passed through blood, semen (pre-ejaculate), vaginal fluids, rectal fluids and saliva from someone who has the virus.  The main ways that hep B is passed between people are:

• Anal or vaginal sex, oral sex, sharing sex toys
• Maternal transmission (during pregnancy or childbirth)
• Sharing needles/syringes or other equipment used to inject drugs (such as cookers, filters, etc) or equipment to snort or smoke drugs such as stems, bills/straws, etc
• Tattoos, body piercing/modifications, acupuncture, manicures or pedicures where non-sterile equipment is used
• Sharing personal hygiene articles such as razors, toothbrushes or nail clippers
• Medical/surgical procedures where infection prevention and control practices are inadequate

• Shaking hands
• Hugs or kisses
• Coughs or sneezes
• Food or water
• Sharing eating utensils
• Breastfeeding

Hepatitis B is diagnosed with a blood test.  This blood test can reveal if an individual currently has hepatitis B, has had hepatitis B in the past (resolved) or has previously received the vaccine.  Most tests are accurate within four weeks of exposure but some people may take as long as 3 to 6 months to test positive. You may be encouraged to return for repeat testing.

Most people clear the virus without treatment within 6 months and develop lifelong immunity (cannot get the infection again).  However, people who cannot clear the virus within 6 months will develop chronic hepatitis B and can transmit the infection even when they don't have symptoms. Children and infants are at particular risk of developing a chronic infection.

• Newborns at risk can receive an immune globulin injection and vaccine at birth.
• You may be referred to a specialist for follow-up. For chronic infections, treatment is available to help prevent further damage to the liver. 
• Your healthcare provider or a public health nurse will help you notify potential contacts to encourage them to be tested for hepatitis B, assess their immune status and provide vaccination if required. Free vaccination if offered by Ottawa Public Health.

• Decrease or eliminate alcohol, drug and/or tobacco use
• Get vaccinated for Hepatitis A
• Talk to your healthcare provider/pharmacist before starting new medications or natural remedies 

• Use an internal or external condom, every time you have vaginal and/or anal sex
• Use water-based or silicone-based lubricants
• If you share sex toys, cover the toy with a condom and clean after each use
• Get tested for Sexually Transmitted Infections (STIs) regularly

• Use new equipment every time you inject, including needles, syringes and all other supplies (like cookers, filters and water)
• Never share equipment with anyone, including your sex partner(s)
• Access Needle and Syringe Programs or Supervised Consumption Services for new equipment and harm reduction services