Hepatitis

What is hepatitis?

Hepatitis is an inflammation of the liver. The group of viruses that infect the liver are called hepatitis viruses. Some types of hepatitis can cause very serious diseases and — in extreme cases — may lead to death. This brochure will discuss three types of hepatitis virus that can be sexually transmitted.

One type is hepatitis C (HCV), which is passed through direct contact with an infected person's blood. It can spread during sex, but this is very rare. HCV is more likely to be spread during sex if either of the sex partners also has another sexually transmitted infection. For most people HCV is a long-term infection and causes chronic liver disease.

Another type is hepatitis A (HAV). A person can get hepatitis A from infected fecal matter that gets into the mouth — from contaminated food, for example. This infection usually spreads when people do not wash their hands after using the bathroom. HAV can pass from one sex partner to another. Hepatitis A is not a long-term infection. A person can only get the infection once.

The type of hepatitis most likely to be sexually transmitted is hepatitis B (HBV). It is spread through semen, vaginal fluids, saliva, blood, and urine.

How many people have hepatitis B?

About 78,000 American women, men, and children become infected with HBV each year. One out of 20 people in the U.S. will become infected with HBV sometime during their lives. Most of these infections occur among people who are 20 to 49.

What are the symptoms of hepatitis B?

About 50 percent of adults with HBV never have symptoms. When symptoms do occur, they appear between six weeks and six months after infection.

Common initial symptoms include

• extreme fatigue
• tenderness and pain in the lower abdomen
• loss of appetite
• nausea, vomiting
• pain in the joints
• headache
• fever
• hives

Later symptoms include

• more severe abdominal pain
• dark urine
• pale-colored bowel movements
• jaundice — yellowing of the skin and eyes

How are the hepatitis viruses diagnosed?

Hepatitis is diagnosed through a blood test.

How is hepatitis B spread?

Hepatitis B is very contagious. It is passed through an exchange of semen, vaginal fluids, saliva, blood, and urine by

• having sexual intercourse without a latex or female condom
• having unprotected oral sex
• sharing needles and other "works" to inject drugs
• sharing personal hygiene utensils such as toothbrushes and razors
• accidental pricks with contaminated needles in the course of health care

HBV can also be passed from mother to infant during birth.

Can a pregnant woman reduce the risk of passing hepatitis B on to her baby?

Pregnant women who know they may have been exposed to hepatitis B should be tested before giving birth. Other women should consider testing. Unless treated at birth, more than 90 percent of infants born to women with HBV will carry the virus. Immediate treatment of the infant can be 90 to 95 percent effective. Treatment includes a shot of hepatitis B immune globulin (HBIG) and a vaccine at birth. Two follow-up doses of the vaccine should be given during the next six months.

Is there a cure for hepatitis B?

Vaccines Hepatitis B is the only sexually transmitted infection that is preventable with a vaccine. The vaccine is routinely given to infants and children up to 18 years of age. But adults who are at risk for getting HBV should also get vaccinated. The HBV vaccine is usually given in three scheduled doses spread over the course of four to six months. The HBV vaccine has been very successful at reducing the number of people with HBV. The number of people who get HBV each year has dropped from 260,000 in the 1980s to 78,000 in 2001. There is a vaccine for people at risk for hepatitis A, too. Ask your clinician about the risk factors for HAV.

No, there is no medicine that can cure hepatitis infection. But in most cases, 90 to 95 percent of adults with HBV recover completely — hepatitis B goes away by itself within 4 to 8 weeks.

However, about five to 10 percent of people who get HBV as adults will be "carriers" and have chronic (long-term) infection with HBV. Ninety percent of infants who get HBV at birth will have chronic infection unless they receive immediate treatment. Most HBV carriers remain contagious for the rest of their lives. There are about 1.25 million HBV carriers in the U.S.

There are three drugs that can help treat chronic hepatitis B — adefovir dipivoxil, alpha interferon, and lamivudine. But pregnant women can't use these drugs.

Is hepatitis B dangerous?

Nearly 1.25 million people have chronic hepatitis B infection. HBV carriers are more likely to pass the infection to other people. Chronic HBV infections can lead to severe liver disease — including liver damage (cirrhosis) and liver cancer. Death occurs in 15-25 percent of chronic HBV infections.

Who is most likely to get hepatitis B?

• people who have multiple sex partners
• people whose sex partners have multiple sex partners
• people who don't use condoms
• people with a history of other sexually transmitted infections
• babies born to mothers with HBV
• injection drug users
• people who live with someone with chronic HBV
• health care workers

How can people with hepatitis avoid spreading it?

Partners with HBV can reduce the risk of infection by using latex or female condoms every time.

How can I avoid getting hepatitis B?

If you are exposed to the semen, vaginal fluids, blood, or urine of someone with HBV and you have not already received the HBV vaccine, see your health care provider as soon as possible. You can reduce your risk of infection by getting treatment — HBIG and the HBV vaccine — within 14 days after being exposed.

• Get the hepatitis B vaccine.
• Use a latex or female condom every time you have sex.
• Abstain from sexual intercourse.
• Don't "shoot" drugs, especially with "unclean" needles or "works."
• Don't share items such as razors or toothbrushes — they may have infected blood on them.

Where can I get tested and treated for hepatitis?

Planned Parenthood health centers, other clinics, doctors, and health departments offer testing, treatment, and counseling.

Where can I get more information about hepatitis B?

Contact the Hepatitis B Foundation
700 East Butler Avenue
Doylestown, PA 18901-2697
1-215-489-4900
www.hepb.org

Written by Danielle Dimitrov
Updated February 2004.
© 2004 Planned Parenthood Federation of America, Inc. All rights reserved.