What is hepatitis B?
Hepatitis B is a form of hepatitis caused by a virus (HBV) that infects the liver. It’s really easy to pass on through sex. You can get vaccinated against hepatitis B (usually in a combined hep A and B vaccine). All gay and bisexual men should get vaccinated, especially if they have sex with a lot of men.
How common is hepatitis B?
Many gay and bisexual men have had hepatitis B, and clinics offer vaccination against it for free. Most people are diagnosed with it by their doctor.
Hepatitis B is very infectious and can easily be passed on during sex. Many people get it without realising. For others it can mean months of feeling ill and not being able to drink alcohol or take party drugs – often for up to a year.
If you have another liver problem (for example if you have hepatitis C), picking up hepatitis B can be very bad news. Some people don’t fully recover and become carriers, which means that they can give it to others.
Hepatitis B kills about 1 per cent of those who get it.
What are the symptoms of hepatitis B?
Many people have no obvious symptoms when they get hepatitis B. But weeks, or even several months, after getting infected you may get a flu-like illness which can be mild or more severe.
Other symptoms can include:
- fever or diarrhoea
- feeling sick when faced with tobacco smoke, fatty food or alcohol
- having no appetite
- feeling pain in your stomach
- itchy skin
- losing weight.
You may get jaundice, which means:
- your skin and the whites of your eyes turn yellow
- your shit goes a pale colour
- your piss is dark-coloured.
The vast majority of people get over their symptoms, suffer no lasting damage and stop being infectious. About one in 10 people who get the virus become carriers, which means that they feel fine but can still infect other people. Carriers run a small risk of getting liver disease or cancer.
How is hepatitis B passed on?
The hepatitis B virus is usually in:
The virus is a lot more infectious than HIV, so it’s much easier to get or pass on through sex. It can be passed on through unprotected:
- fucking or being fucked
- ‘watersports’, though this is rare
- kissing (also rare).
The virus can also be passed on by:
- sharing toothbrushes or razors, as they could have infected blood on them
- sharing anything used to take drugs or steroids (such as rolled up bank notes, pipes, injecting equipment and so on)
- piercing, tattooing, acupuncture or sex play with needles if hygiene guidelines aren’t followed
- sharing sex toys as the virus can live in dried blood for a week or so.
How is hepatitis B prevented?
You can protect yourself from hepatitis B by getting vaccinated. Gay and bisexual men are at greater risk of hepatitis B, so sexual health clinics and some GPs offer free vaccinations.
Until you do, the risk can be reduced by:
- using condoms for fucking and sucking and latex gloves for fisting
- not sharing anything used to take drugs or steroids, such as rolled up bank notes, pipes, injecting equipment and so on
- avoiding ‘do-it-yourself’ or amateur piercing or tattooing as contaminated equipment might be used or shared
- avoiding sharing sex toys unless they are covered with a fresh condom for each person they’re used on or washed with a solution of one part bleach to 10 parts water
- avoiding contact with blood during play piercing or any sex scene that draws blood.
Vaccination and HIV
You can be safely vaccinated if you have HIV; in fact, it’s recommended that people with HIV get the vaccine. Vaccines have a short-lived effect on your viral load, so tell the person vaccinating you that you have HIV and let the doctor treating your HIV know that you’re being vaccinated.
HIV-positive people who have HBV infection are more likely to develop chronic hepatitis B.
How is hepatitis B treated?
You may need plenty of rest if you get hepatitis B, which can mean many weeks off sick. You may have to stop drinking alcohol, smoking and avoid party drugs for up to a year while your liver recovers.
If tests show you’re a carrier, drugs may be able to control the virus.
Last review: 09/11/2018
Next review: 09/11/2021