BBVAware Training Session - Hepatitis B

Module 2 - What is hepatitis?

Hepatitis means inflammation of the liver.

When the liver is damaged by viruses, alcohol, drugs or over-consumption of other toxins, people can develop hepatitis. In less common cases, people can get hepatitis because their immune system stops working properly.

5 types of viral hepatitis

There are 5 viruses known to infect and inflame the liver. These are hepatitis A, B, C, D and E.

The symptoms of all five viruses can be similar. The main difference is the way they are transmitted and the effects they have on people’s health.

The 2 most common types of liver inflammation are hepatitis B and hepatitis C.

Hepatitis B (HBV) is a blood-borne virus and can be sexually transmitted. There is a safe and effective vaccine to protect people against hepatitis B. Treatment is available, but there is no cure.
Hepatitis C (HCV) is a bloodborne virus. Without treatment, hepatitis C can cause liver disease and liver cancer. However, Hep C is more than 95% curable.

According to Hepatitis Australia, approximately 356,655 Australians are currently living with chronic hepatitis B and C. Many more people don’t even know they have hepatitis.

Other types of viral hepatitis are:

Hepatitis A (HAV) is most often spread when a person consumes food or drink contaminated by very small particles of infected faeces (poo). This is usually due to poor sanitation or when hands are not washed thoroughly. It can have serious (but short-lived) symptoms and people generally recover fully.
Hepatitis D (HDV) is caused by the hepatitis delta virus and only affects people who already have hepatitis B. Hepatitis D can make hepatitis B worse, leading to a greater likelihood of liver failure, rapid progression to liver cirrhosis, and greater risk of developing liver cancer. Transmission of hepatitis D can occur either via simultaneous infection with hepatitis B (co-infection) or superimposed on chronic hepatitis B or hepatitis B carriers (superinfection).
Hepatitis E (HEV) is similar to hepatitis A. It is most often spread when a person consumes food or drink contaminated by very small particles of infected faeces (poo). It can have serious (but short-lived) symptoms and people generally recover fully. It is extremely rare in Australia.

Common ways to contract hepatitis

This animated cartoon by the World Health Organization (WHO) shows common ways people can contract hepatitis and safe practices to avoid it.

Hepatitis B

Hepatitis B (known as HBV) is the most common liver virus in the world.

HBV can be transmitted through:

Semen, vaginal fluid and blood
Sexual contact
Sharing of injecting equipment
Birth, from mum to baby
Tattooing, body piercing or medical procedures with unsterile equipment
Sharing of toothbrushes, razors or nail files
Uncovered cuts or sores.

The most common time people get hepatitis B is early in life. If women are pregnant and have hepatitis B, the baby should get an injection within 12 hours of being born. This injection contains the first dose of vaccine, as well as HBV antibodies that help the immune system to fight the virus.

This injection, together with the rest of the vaccine course, is very effective at protecting the baby against hepatitis B.

People can get treatment to manage chronic hepatitis B, but not to cure it.

What you need to know about hepatitis B

Common myths about hepatitis B

Hepatitis B can not be transmitted through:

Saliva
Hugging or kissing
Sharing food or eating utensils
Eating food prepared by someone with hep B
Insect or animal bites, including mosquitoes
Sharing bathrooms, showers or toilets
Coughing or sneezing.

What happens if someone contracts hepatitis B?

Many people with hepatitis B have no symptoms. It’s important to get regular liver check-ups, even if people don’t feel sick.

If someone contracts hepatitis B, the body’s immune system will try and fight the virus. There are 2 possible outcomes: people can either get an acute or chronic illness.

Acute hepatitis B means the virus causes sickness for a short time but then people will recover. Some people with acute hep B naturally clear the virus. If the virus stays in the liver for more than 6 months, then the disease progression is classed as chronic hepatitis B.
Chronic hepatitis B means the virus stays in the liver for the whole of a person’s life. People may not always feel sick, but over time the virus can destroy the liver and cause cirrhosis.

Who is most at risk?

People are recommended to get the hepatitis B vaccine according to the Australian Immunisation Handbook (ATAGI 2018).

People who are most at risk (including)
- Infants, children and adolescents
- Aboriginal and Torres Strait Islander peoples
- People travelling to countries with higher levels of hepatitis B
People who are immunocompromised (including)
- people living with HIV
- dialysis patients and people with severely impaired kidney function
- people about to receive an organ transplant
- people who have received a stem cell transplant.
People with other medical conditions (including)
- people with chronic liver disease and/or hepatitis C
- people who receive certain blood products
- people with developmental disabilities who attend day-care facilities.
People who are at risk because of their job (including)
- people who work in any occupation that involves direct patient care, handling human tissue, blood or bodily fluids, or used needle and syringes
- healthcare workers
- police, members of the armed forces, emergency services staff, and correctional facilities staff
- funeral workers, embalmers
- staff involved in the care of people with developmental disabilities
- workers who perform skin penetrating procedures, such as tattooists and body piercers.
Other groups (including)
- household or other close contacts of people living with hepatitis B
- sexual contacts of people living with hepatitis B
- men who have sex with men
- migrants from countries with higher levels of hepatitis B
- people who inject drugs
- inmates in correctional facilities
- sex industry workers.

Diagnosis and treatment

Blood tests are used to diagnose hepatitis B.

If someone does have the virus, then a GP or specialist may do other tests to check if the liver has been damaged.

Tests for hepatitis B are not part of regular blood tests – people have to ask for them. If a person tests negative for these tests, they should ask their GP about getting the hep B vaccination.

Hepatitis B is effectively managed by taking antiviral medication regularly.

Quiz Time

Next training module

Module 3

Hepatitis C