Here are some of the questions that are most frequently posed about Hepatitis B. While answers to new questions submitted by subscribers are answered by members of the Hepatitis Week Medical Advisory Board, the FAQ data base draws heavily on responses developed by the Centers for Disease Control and Prevention, the National Institute of Health, and the Veterans Administration. If you have questions that are not answered in our FAQ Archive, feel free to submit them via email to editor@hepatitisweek.org.

What is hepatitis B?

Hepatitis B is a liver disease. It makes your liver swell and stops it from working right. You need a healthy liver. The liver does many things to keep you alive. The liver fights infections and stops bleeding. It removes drugs and other poisons from your blood. The liver also stores energy for when you need it.

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What causes hepatitis B?

Hepatitis B is caused by a virus. A virus is a germ that causes sickness. (For example, the flu is caused by a virus.) People can pass viruses to each other. The virus that causes hepatitis B is called the hepatitis B virus (HBV).

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Is hepatitis B serious?

Yes. Although many people who are exposed to hepatitis B will be able to get rid of the virus, some people develop chronic (life-long) hepatitis B. This may lead to liver damage, liver cancer and death. Hepatitis B carriers are people who are infected with HBV and never recover fully from the infection; they carry the virus and can infect others for the rest of their lives. In the United States, about one million people carry HBV.

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How do you get hepatitis B?

You get hepatitis B by direct contact with the blood or body fluids of an infected person. You could get hepatitis B by:

• Having sex with an infected person without using a condom.
• Sharing drug needles.
• Getting a tattoo or body piercing with dirty tools that were used on someone else.
• Getting pricked with a needle that has infected blood on it (health care workers can get hepatitis B this way).
• Sharing a toothbrush or razor with an infected person.
• An infected woman can give hepatitis B to her baby at birth or through her breast milk.

You can NOT get hepatitis B by:

• Shaking hands with an infected person.
• Hugging an infected person.
• Sitting next to an infected person.

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Who is at risk?

One out of 20 people in the United States will get infected with HBV some time during their lives. In 1999, an estimated 80,000 persons in the U.S. were infected with HBV. People of all ages get hepatitis B and about 5,000 die per year of sickness caused by HBV.

Your risk is higher if you:

• Have sex with someone infected with HBV.
• Have sex with more than one partner.
• Are a man and have sex with a man.
• Live in the same house with someone who has lifelong HBV infection.
• Have a job that involves contact with human blood.
• Shoot drugs.
• Are a patient or work in a home for the developmentally disabled.
• Have hemophilia. Travel to areas where hepatitis B is common.
• Have parents who were born in Southeast Asia, Africa, the Amazon Basin in South America, the Pacific Islands, and the Middle East.

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How do you know if you have hepatitis B?

You may have hepatitis B (and be spreading the disease) and not know it; sometimes a person with HBV infection has no symptoms at all. Only a blood test can tell for sure.

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What are symptoms of hepatitis B?

Hepatitis B can make you feel like you have the flu. You might:

• Feel tired.
• Feel sick to your stomach.
• Have a fever.
• Not want to eat.
• Have stomach pain.
• Have diarrhea.

Some people have:

• Dark yellow urine.
• Light-colored stools.
• Yellowish eyes and skin.

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What are the tests for hepatitis B?

To check for hepatitis B, the doctor will test your blood. These tests show if you have hepatitis B and how serious it is. Tests for hepatitis B include:

Anti-HBs (hepatitis B surface antibody). If this test is positive,

• It means that you have antibodies against hepatitis B, and are safe from getting the disease;
• You were either vaccinated against hepatitis B or exposed to it at some point in your lifetime.

Anti-HBc (hepatitis B core antibody).

• If this test is positive,
• It means that you have been exposed to hepatitis B and have developed an antibody to only part of the virus;
• More tests will be needed to find out if you have the disease.

HBsAg (hepatitis B surface antigen). If this test is positive,

• It means that you do have hepatitis B and can spread the virus to others

HBeAg (hepatitis B e antigen).

If this test is positive,

• It means that you have high levels of virus in your blood; you may be very contagious to others.

The doctor may also do a liver biopsy. The doctor removes a tiny piece of your liver through a needle. The doctor checks the piece of liver for signs of hepatitis B and liver damage.

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How is hepatitis B treated?

Treatment for hepatitis B may involve:

• A drug called interferon. It is given through shots. Most people are treated for 4 months.
• A drug called lamivudine. You take it by mouth once a day. Treatment is usually for one year. Sometimes lamivudine is combined with interferon.
• Surgery. Over time, hepatitis B may cause your liver to stop working. If that happens, you will need a new liver. The surgery is called a liver transplant. It involves taking out the old, damaged liver and putting in a healthy one from a donor

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How can I protect myself?

You can get the hepatitis B vaccine. A vaccine is a drug that you take when you are healthy that keeps you from getting sick. Vaccines teach your body to attack certain viruses, like the hepatitis B virus.

The hepatitis B vaccine is given through three shots.

All babies should get the vaccine. Infants get the first shot within 12 hours after birth. They get the second shot at age 1 to 2 months and the third shot between ages 6 and 18 months.

Older children and adults can get the vaccine, too. They get three shots over 6 months. Children who have not had the vaccine should get it.

You need all of the shots to be protected. If you miss a shot, call your doctor or clinic right away to set up a new appointment.

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If you are pregnant, should you worry about hepatitis B?

If you have HBV in your blood, you can give hepatitis B to your baby. Babies who get HBV at birth may have the virus for the rest of their lives, can spread the disease, and can get cirrhosis of the liver or liver cancer.

All pregnant women should be tested for HBV early in their pregnancy. If the blood test is positive, the baby should receive vaccine along with another shot, hepatitis B immune globulin (called HBIG), at birth. The second dose of vaccine should be given at 1-2 months of age and the third dose at 6 months of age.

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