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Hepatitis B

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Hepatitis B can affect the liver. It is a potentially fatal virus that is much easier to contract than other forms of hepatitis. It can be passed on through unprotected anal sex, oral sex and very occasionally, kissing.

Symptoms

Many people with Hep B have no symptoms. However, Hep B can cause tiredness, yellowing of the skin and eyes, loss of appetite, stomach pains, darkened piss and pale shit.

Treatment

Hep B is also easily preventable through a short course of injections available free from a GUM clinic or a GP.

Frequently asked questions

Q. What is hepatitis B?

A. Hepatitis B is a viral infection. It is a common infectious disease in gay and bisexual men. Most people recover completely from acute hepatitis B infection but some patients with impaired immune systems will become chronic carriers.

Q. How do I get hepatitis B?

A. The main routes of transmission are:
a: mother to child during delivery
b: sexual contact
c: contact with blood or blood products

Q. Do I need vaccination?

A. If you are not immune to hepatitis B i.e. no hepatitis B surface antibody, you should receive 3 doses of hepatitis B vaccine. You should consult your local GUM clinic for vaccination.

Q. What is the long term outlook for a hepatitis B carrier?

A. A small proportion of hepatitis B carriers will develop chronic hepatitis. Some of these patients will progress into cirrhosis (liver failure) or liver cancer.

Q. Does hepatitis B mean a death sentence?

A. No, only a small proportion of hepatitis B carriers will progress to end stage liver failure or cancer. A majority of patients still remain asymptomatic and healthy. However, carriers should still follow-up with their doctor's office on a regular basis.

Q. What symptoms do I have if I am suffering from hepatitis B infection?

A. Many patients with hepatitis B do not have any symptoms and feel perfectly well. But if the hepatitis B infection becomes active the sufferer may feel ill with nausea, loss of appetite general fatigue, and can get jaundiced.

Q. What do I need to do if I have been diagnosed as having hepatitis B?

A. Do not panic if you hav been diagnosed to have hepatitis B. You should see your doctor/GUM clinic, and depending on the stage of your liver disease, he/she will decide whether you will be followed regularly or if you need to be referred to a liver specialist.

Q. What can a liver specialist do for me if I need to one?

A. The liver specialist will need to perform several more detailed investigations to determine whether the hepatitis B infection has affected your liver. If so, you may need to receive treatment.

Q. Is there any treatment for hepatitis B?

A. Yes, interferon is being used to treat hepatitis B. There are certain criteria for treatment and not everyone will benefit from interferon.

Q. What complications can I expect from the hepatitis B infection?

A. A proportion of patients with hepatitis B can develop hardening of the liver called cirrhosis. A small percentage of patients with cirrhosis have an increased risk of developing liver cancer. However, a large number of patients can just carry the hepatitis B virus for life and do not develop liver disease. There is no way that the doctor can predict who will develop liver cirrhosis or who will develop liver cancer, therefore it is very important that you are followed
up by your doctor regularly.

Q. What kind of outlook can I expect if I have a hepatitis B infection?

A. Many patients with a hepatitis B infection can expect to lead a full and normal life. It is most important to regard yourself as a normal individual who happens to be infected with hepatitis B. However, it is important to take precautions not to spread the disease and get medical checkups regularly.

Q. Am I going to get sick with interferon treatment?

A. Interferon is known to cause some side effects such as headaches, fever, chills, muscle aches, joint aches etc. which are manageable with rest and Tylenol. Side effects are most severe during the first two weeks of treatment only and will usually taper off as treatment continues. There may be some other uncommon side effects such as hair thinning, decreased concentration, mood swings, but they are all transient and reversible.

Q. How is interferon given?

A. Interferon is given with a syringe and a small needle into the fat directly under the skin. You will be taught how to do the injection yourself even though it might sound a bit scary at first. The self-injection is similar to the way insulin is given by diabetics. If you are absolutely terrified with needles, you may want to get family members or friends or even your family doctor involved.

Q. Who should I tell about my hepatitis B?

A. You have an obligation to tell your doctors and dentists about your hepatitis B but not your employer. Tell your friends only if you know that they understand about hepatitis B and will give you support.

Q. As a hepatitis B carrier, do I need to practice safe sex at all times?

A. If you have a steady partner and in a monogamous relationship, your partner should be checked for hepatitis
B and vaccinated if there is no prior exposure to hepatitis B. If you have multiple sexual partners, use of condoms is a must to prevent transmission.

Q. Can I get hepatitis from the vaccine?

A. No. The hepatitis vaccine is a safe and highly purified vaccine. It does not contain any blood products or living or dead viruses.

Q. What is hepatitis C?

A. Hepatitis C is a viral infection.

Q. How do I get hepatitis C?

A. The main routes of transmission are:
a: mother to child during delivery
b: sexual contact
c: contact with blood or blood products

Q. What happens if I get infected?

A. Usually there are no obvious symptoms, 1in 7 people clear the infection the rest go on to develop chronic hepatitis C.

Q. Can I get vaccinated?

A. There is currently no vaccination against Hepatitis C.

Q. What is the long-term prognosis?

A. There are three mains things which can occur.
1. Some people remain completely healthy.
2. Some people experience a mild illness, with symptoms such as chronic fatigue and nausea.
3. The rest develop the severe illness, which can develop over 5-10 years and has effects such as liver damage (cirrhosis) and liver cancer.

Q. Is there a test?

A.Yes, it can be determined which form you have type 1,2 or 3. This is done through a blood test and sometimes a sample of the liver is also taken (biopsy).

Q. Is there any treatment?

A. Like hepatitis B chemotherapy can be used. Drugs such as interferon and ribavarin are used. These are effective for some people. But they bring with them serious side effects.

Q.What about the other forms of Hepatitis?

A.As with hepatitis C there are no vaccinations against hepatitis D, E, F and G and any other forms which are coming to light. however chemotherapy may be effective in treating some of them

Further information

Hepatitis Info from
the British Liver Trust:
http://www.britishlivertrust.org.uk
e info@britishlivertrust.org.uk

or hepatitis@gmh.org.uk

> main GMH hepatitis page

Images courtesy of the Steve Retson Project

If you live outside Edinburgh and the Lothians a full list of GUM clinics in the UK, Ireland and the US is available at http://www.bashh.org/directory.htm

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Last updated 20th May 2004

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