Hepatitis B

Hepatitis B is an infection of the hepatitis B virus (HBV) that causes inflammation of the liver. Once an adult has contracted acute hepatitis B there is a 95% probability that they will recover and develop natural immunity. The remaining 5% of people with acute hepatitis B will develop persisting chronic hepatitis B (though the acute symptoms subside) and will be able to pass on the virus in the long term. If chronic hepatitis B is not diagnosed and managed, it can lead to super infection with hepatitis D, cirrhosis (scarring of the liver) and potentially cancer of the liver.

Transmission

Hepatitis B can be transmitted through:

  • The exchange of blood and body fluids, including semen, vaginal and anal secretions
  • Sharing syringes or injecting equipment
  • Sharing piercing, cutting and tattooing equipment
  • Sharing toothbrushes, razors, or hair and nail clippers
  • Breast feeders with cracked and bleeding nipples could pose a risk of blood to blood contact while breastfeeding if their baby has small tears or scratches in or around their mouths
  • Mother to baby during childbirth, however administration of the hepatitis B vaccine within 12 hours of birth can significantly reduce the risk of transmission

Signs and Symptoms

The symptoms of acute hepatitis B may start from two months and persist for up to twelve months:

  • Abdominal pain or liver pain (top right side of the abdomen)
  • Loss of appetite, nausea and vomiting
  • Weight loss
  • Jaundice
  • Pale coloured faeces and dark urine
  • Fatigue, fever and feeling unwell
  • Muscle and joint pain
  • Often asymptomatic

Prevention

Vaccination against hepatitis B is available and will provide lifelong immunity. Sex workers should consider having the combined hepatitis A/hepatitis B vaccination.

  • Use condoms and dams to prevent contact with blood and bodily fluids
  • Avoid sharing razors, toothbrushes, skin piercing or hair and nail clippers or equipment that could have come in contact with contaminated blood or fluids.
  • Don’t share syringes or injecting equipment
  • Always wash hands thoroughly if contact has occurred with someone else’s bodily fluids or blood
  • Cover any cuts or open sores on the body to avoid contact with someone else’s bodily fluids
  • If exposed to the bodily fluids or blood of someone with chronic hepatitis B and unsure about personal immunity, see a doctor as soon as possible. An injection called hepatitis B immunoglobulin may be given within 72 hours of exposure to provide immediate protection. Additionally, a dose of hepatitis B vaccine is needed as soon as possible or within 7 days of exposure.
  • If possible, wear disposable gloves

Treatments for chronic Hepatitis B

There are many treatments for managing the effects of chronic hepatitis B called antiviral medications, but there is no cure. They are prescribed by a medical specialist called a Hepatologist and can help slow the virus from progressing. Generally, chronic hepatitis B that has not caused liver damage does not need treatment. However, it is important for people with hepatitis B to closely monitor their liver with regular six monthly liver function tests.

Sex workers should consider getting vaccinated for hepatitis B. The vaccination is administered in three doses over a period of six months.

Maintaining a balanced diet, and avoiding alcohol and drugs which can harm the liver can help limit the amount of liver inflammation.

In some Australian states and territories, there are various laws governing sex workers living with chronic hepatitis B such as compulsory disclosure to clients before sex service or it may be against the law to work as a sex worker living with  chronic hepatitis B. Contact your local sex worker organisation to find out more information.