Hepatitis B
Hepatitis B is a potentially life-threatening viral infection of the liver that can cause acute and chronic disease. It is most prevalent in sub-Saharan Africa, most of Asia and the Pacific islands.1,2Key facts
- Hepatitis B is a potentially life-threatening infection of the liver, caused by the hepatitis B virus (HBV)1
- It is estimated that 296 million people worldwide had chronic HBV infection in 2019, with 1.5 million newly infected that year. Approximately 820,000 deaths occurred in 2019 because of HBV1
- Hepatitis B is the most prevalent in sub-Saharan Africa, Asia and the Pacific islands2
- Travellers to areas of intermediate or high endemicity are at increased risk of hepatitis B infection, which occurs through contact with infectious bodily fluids1,2
- Some people are at higher risk of hepatitis B because of their lifestyle, occupation or co-existing medical condition(s)2
- Acute infections are mostly asymptomatic but can develop into chronic hepatitis B, which can lead to progressive liver disease with a high mortality rate, such as cirrhosis and liver cancer1
- There is no treatment for acute hepatitis B, but chronic hepatitis B can be treated with oral antiviral agents1
What is hepatitis B?
Hepatitis B is a potentially life-threatening viral infection. The hepatitis B virus (HBV) infects the liver – this can be an acute or chronic infection. Chronic infection puts people at higher risk of death from cirrhosis and liver cancer.1,3 HBV is most commonly transmitted from mother to child during birth and delivery, and through contact with bodily fluids of an infected person through the skin or mucous membranes.1,3
Risk areas hepatitis B
Adapted from Schweitzer, et al. 20154.
Where does hepatitis B occur?
The prevalence of hepatitis B is highest in sub-Saharan Africa, most of Asia and the Pacific islands. Intermediate-prevalence regions include the Amazon, certain parts of Eastern and Central Europe, the Middle East and the Indian sub-continent.2
Who is at risk of contracting hepatitis B?
Travellers to areas of intermediate or high endemicity are at increased risk of hepatitis B infection. The risk increases with staying for longer periods of time, having a pre-existing or chronic medical condition that may require hospital treatment, and travelling for medical or dental treatment. Engaging in higher-risk activities, such as healthcare or aid work, sexual activity, injecting drug use, acupuncture, piercing, tattooing, public shaving or contact sports also increase the risk of contracting hepatitis B for travellers.2,5
Certain occupations are also considered at increased risk of infection because people are more likely to be directly exposed to bodily fluids or tissues in their job.2 This includes healthcare workers, laboratory staff, morticians, embalmers, medical cleaners, prison service staff, foster carers, emergency service personnel, sewage workers, tattooists and piercers.2,6,7
How do you get hepatitis B?
Hepatitis B is most commonly transmitted from infected mother to child during birth and delivery.1 Transmission between adults occurs via contact of infections bodily fluids of an HBV carrier (e.g. saliva, blood, menstrual fluid, vaginal or seminal fluid) through the skin or mucous membranes of an uninfected person. This can occur with needlestick injury, biting, sexual contact, piercing, tattooing and reuse of contaminated needles.1,2,8 Notably, HBV can survive outside the body for at least 7 days and can still cause infection if it enters the body of an uninfected person.1,3
What are the symptoms and lasting effects of hepatitis B?
Most people will not experience symptoms when newly infected with HBV. Those acutely infected who do experience symptoms report fatigue, nausea, vomiting, abdominal pain and jaundice (yellowing of the skin and eyes). Acute HBV infection can lead to liver failure, which may result in death. An acute infection can also become chronic, potentially causing long-term complications, such as cirrhosis and liver cancer, which are often fatal.1 Less than 5% of adults infected with HBV will develop chronic hepatitis, however infection early in life leads to chronic disease in about 95% of cases.1
How can hepatitis B be treated?
There is no treatment for acute hepatitis B. Ensuring comfort and adequate hydration, as well as avoiding unnecessary medications, including paracetamol, is suggested.1
Chronic hepatitis B can be treated using oral antiviral agents. They help slow disease progression, thus improving survival. However, most patients who begin treatment (12% – 25% of those with chronic infection) must continue it for life.1
How can you prevent hepatitis B?
For advice about preventing hepatitis B infection speak to your GP, visit a pharmacy or a specialist clinic.
Useful links
References
- World Health Organization. Factsheet: Hepatitis B. June 2022. Available online: who.int. (Last accessed March 2023)
- Public Health England. Immunisation against infectious disease. Hepatitis B: the green book, chapter 18. February 2022. Available online: gov.uk. (Last accessed March 2023)
- Centers for Disease Control and Prevention. Hepatitis B Information. Available online: cdc.gov. (Last accessed March 2023)
- Schweitzer A, Horn J, Mikolajczyk RT, et al. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015;386(10003):1546-55
- National Travel Health Network and Centre (NaTHNaC). Travel Health Pro. Hepatitis B. November 2019. Available online: travelhealthpro.org.uk. (Last accessed March 2023)
- Superdrug Health Clinics. Corporate Occupational Health Vaccinations – Hepatitis B. Available online: healthclinics.superdrug.com. (Last accessed March 2023)
- Public Health England. Tattooing and body piercing guidance toolkit. August 2013. Available online: gov.uk. (Last accessed February 2023)
- Centers for Disease Control and Prevention. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR 2018;67(1);1–31. Available online: cdc.gov. (Last accessed March 2023)
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