Hepatitis (hep-uh-tahy-tis) B is a liver disease caused by the Hepatitis B virus (HBV). It ranges in severity from a mild illness lasting a few weeks (acute), to a serious long-term (chronic) illness that can lead to liver disease or liver cancer.
Transmission: Contact with infectious blood, semen, and other body fluids from having sex with an infected person, sharing contaminated needles to inject drugs, or from an infected mother to her newborn.
Vaccination: Hepatitis B vaccination is recommended for all infants, older children and adolescents who were not vaccinated previously, and adults at risk for HBV infection.
Frequently Asked Questions about Hepatitis B
How is Hepatitis B spread?
- Hepatitis B is usually spread when blood, semen, or other body fluids from an infected person enter the body of someone who is not infected. This can happen through sexual contact with an infected person or sharing needles, syringes, or other injection drug equipment.
- Hepatitis B can also be passed from an infected mother to her baby at birth.
- The virus is very infectious and is easily passed through breaks in the skin or in soft tissue such as the eyes, nose, and mouth.
- The virus can live on objects for up to 7 days and individuals can also become infected from contact with contaminated objects.
- The Hepatitis B virus is 50-100 times more infectious than HIV.
Hepatitis B is not spread by:
- Hepatitis B is NOT spread through breastfeeding, sharing eating utensils, hugging, kissing, holding hands, coughing, or sneezing. Unlike some forms for hepatitis, Hepatitis B is NOT spread through contaminated food or water.
Can a person get Hepatitis B from a tattoo or piercing?
- There is little evidence that Hepatitis B is spread by getting tattoos in licensed, commercial facilities. Whenever tattoos or body piercings are given in an informal setting or with non-sterile instruments, transmission of Hepatitis B and other infectious diseases are possible.
What are the symptoms of acute Hepatitis B?
- It’s important to know that not everyone has symptoms with acute Hepatitis B, especially young children. Even people without symptoms can still spread the virus to other and the virus can be detected in their blood. For those people who do have symptoms, they will typically appear within 3 months of exposure. Symptoms can last from a few weeks to several months and include:
Fever Vomiting Joint pain
Fatigue Abdominal pain Yellowing of the skin and whites of eyes
Loss of appetite Grey-colored stools
Nausea Dark urine
What are the symptoms of chronic Hepatitis B?
- Many people with chronic Hepatitis B do not have symptoms and do not know they are infected. Even people without symptoms can spread the virus to others and the virus can still be detected in their blood. Symptoms of chronic Hepatitis B can take up to 30 years to develop. Damage to the liver can silently occur during this time. When symptoms do appear, they are similar to those of acute Hepatitis B infection and can be a sign of advanced liver disease.
Is Hepatitis B common?
- Yes, in the United States, approximately 1.2 million people have chronic Hepatitis B. Unfortunately, many people do not know they are infected. An estimated 40,000 people now become infected each year.
How serious is Hepatitis B?
- Over time, approximately 15%-25% of people with chronic Hepatitis B develop serious liver problems, including liver damage, cirrhosis, liver failure, and liver cancer. Every year, approximately 3,000 people in the United States and more than 600,000 people worldwide die from Hepatitis B related liver disease.
How is Hepatitis B diagnosed?
- Hepatitis B is diagnosed with specific blood tests that are not part of blood work typically done during regular physical exams.
- Typically, a person first gets a screening test that looks for “antibodies” to the Hepatitis B virus.
- Antibodies are proteins released by the body, into the bloodstream, when a person becomes infected. The antibodies remain in the bloodstream, even if the person clears the virus.
- If the screening test is positive for Hepatitis B antibodies, different blood test are needed to determine whether the infection has been cleared or has become a chronic infection.
- There are many different blood tests available to diagnose Hepatitis B. They can be ordered as an individual test or as a series of tests. Ask your health professional to explain what he or she hopes to learn from the tests and when you will get the results.
How long does it take for blood to test positive after exposure to Hepatitis B Virus (HBV)?
- After exposure to the virus, it takes an average of 4 weeks (range: 1-9 weeks) before the blood test is positive for Hepatitis.
How is Hepatitis B treated?
- For acute Hepatitis B, doctors usually recommend rest, adequate nutrition, fluids, and close medical monitoring. Some people may need to be hospitalized.
- Those living with chronic Hepatitis B should be evaluated for liver problems and monitored on a regular basis. Even though a person may not have symptoms or feel sick, damage to the liver can still occur. Several new treatments are available that can significantly improve health and slow the virus’ effects on the liver.
What should I do if I think I’ve been infected?
- If you think you have been exposed to the blood or body fluid of an infected individual, notify your primary care physician immediately.
Can I stay in the Army if I am diagnosed with Hepatitis B?
- Persons diagnosed with Hepatitis B can remain on Active Duty but are not deployable into combat theaters. AR 40-501 requires a Medical Evaluation Board (MEB) for persons with chronic Hepatitis B when symptoms persist and there is evidence of impaired liver function.
Preventing Hepatitis B
Can Hepatitis B be prevented?
- Yes. The best way to prevent Hepatitis B is by getting vaccinated. For adults, the Hepatitis B vaccine is given as a series of 3 shots over a period of 6 months. The entire series is needed for long term protection. Booster doses are not currently recommended.
- To reduce the risk of becoming infected with the Hepatitis B virus
- Do not share needles or other equipment to inject cosmetic substances, drugs, or steroids.
- Do not use personal items that may have come into contact with an infected person’s blood, such as razors, nail clippers, toothbrushes, or glucose monitors.
- Do not get tattoos or body piercing from an unlicensed facility or in an informal setting.
- Do not have unprotected sexual encounters
Who should get vaccinated against Hepatitis B?
- Vaccination is recommended for certain groups, including:
- All infants at birth
- Healthcare and public safety workers at risk for occupational exposure to blood or bodily fluids
- Military personnel
- Anyone having sex with an infected partner
- People with multiple sex partners
- Anyone with a sexually transmitted infection
- Men who have sexual encounters with other men
- People who inject drugs
- People who live with someone with Hepatitis B
- People with chronic liver disease, end stage renal disease, or HIV infection
- Some travelers, depending on the potential risk in their travel plan
How can I make sure my family is protected from Hepatitis B?
- Cover cuts and sores: Since Hepatitis B is spread through blood, people with Hepatitis B should be careful not to expose other people to things that could have their blood on them. The virus can live on contaminated surfaces for up 7 days. It’s important not to share personal items such as razors, nail clippers, toothbrushes, or glucose monitors. Cuts and sores should be covered while they are healing.
- Do not chew food for your baby: Tiny amounts of blood can sometimes be in a person’s mouth. Do not pre-chew food before you feed it to your baby.
Hepatitis B and Pregnancy
Can Hepatitis B be spread to babies?
- Yes. The Hepatitis B virus can be spread to a baby during childbirth. This can happen during a vaginal delivery or a cesarean section.
- When babies become infected with Hepatitis B, they have a 90% chance of developing a lifelong, chronic infection that may result in liver damage, disease, or cancer over time.
Are pregnant women tested for Hepatitis B?
- Yes. Pregnant women are routinely tested for Hepatitis B, along with other diseases. Many women do not know they are infected, since people with Hepatitis B often have no symptoms.
- The test is usually performed during the first prenatal visit. If a woman has not received prenatal care, then she will be tested at the hospital before she delivers her baby.
Can doctors prevent a baby from getting Hepatitis B?
- Yes. Babies born to women with Hepatitis B get two shots soon after birth. One is the first dose of the Hepatitis B vaccine and the other shot is called HBIG. The two shots help prevent the baby from getting Hepatitis B. The shots work best when they are given within 12 hours after delivery.
- HBIG stands for Hepatitis B Immune Globulin and is a medicine that gives baby’s body a “boost” or extra help to fight the virus as soon as he or she is born. The HBIG shot is only given to babies of mothers who have Hepatitis B.
How many Hepatitis B shots does my baby need?
- All babies receive the Hepatitis B vaccine, regardless of the mother’s Hepatitis B status.
- Your baby will get 3 or 4 shots, depending on which brand of vaccine is used. After the first dose is given in the hospital, the next dose is given at 1-2 months of age. The last dose is usually given by the time your baby is one year old. All of the Hepatitis B shots are necessary to help keep your baby from getting the virus.
- If you know that you have Hepatitis B, your baby’s blood will be tested after he or she receives all of the Hepatitis B shots. The blood test will determine if your baby is protected and does not have Hepatitis B. The blood test is usually done 1-2 months after the last shot. Be sure to bring your baby back to your doctor for this important blood test.
Army Regulation 40-501.Standards of Medical Fitness. 4 Aug 2011
Centers for Disease Control and Prevention (CDC). (2012). Hepatitis B FAQs for the Public. http://www.cdc.gov/hepatitis/B/bFAQ.htm
Centers for Disease Control and Prevention (CDC). (2010). General Information Hepatitis B. http://www.cdc.gov/hepatitis/HBV/PDFs/HepBGeneralFactSheet.pdf
Centers for Disease Control and Prevention (CDC). (2010). When a Pregnant Woman Has Hepatitis B. http://www.cdc.gov/hepatitis/HBV/PDFs/HepBPerinatalProtectWhenPregnant.pdf
Centers for Disease Control and Prevention (CDC) (2010). Hepatitis B and Your Baby. http://www.cdc.gov/hepatitis/HBV/PDFs/HepBPerinatal-ProtectHepBYourBaby.pdf