Hepatitis B (hep B) is a virus that affects the liver. Someone can live with hep B for a long time (20-30 years) before they develop any symptoms, feel sick, or see any sign of liver damage. Without testing, treatment or follow-up from a provider, the liver can become scarred and cause people to become ill.

Hep B can be very common in certain parts of the world, such as sub-Saharan Africa, East Asia, parts of Central and South America.

Most people have no signs or symptoms of hep B. People who have hep B may have some or all of the following symptoms:

• Fatigue (feeling tired)
• Jaundice (yellowing of the skin and whites of the eyes)
• Dark urine, pale stools
• Abdominal pain, nausea, vomiting, poor appetite

The hep B virus is passed through blood, semen (pre-ejaculate), vaginal fluids, rectal fluids and saliva from someone who has the virus. The main ways that hep B is passed between people are:

• Anal or vaginal sex, oral sex, sharing sex toys
• Maternal transmission (during pregnancy or childbirth)
• Sharing needles/syringes or other equipment used to inject drugs (such as cookers, filters, etc) or equipment to snort or smoke drugs such as stems, bills/straws, etc
• Tattoos, body piercing/modifications, acupuncture, manicures or pedicures where non-sterile equipment is used
• Sharing personal hygiene articles such as razors, toothbrushes or nail clippers
• Medical/surgical procedures where infection prevention and control practices are inadequate

Hepatitis B cannot be passed through :

• Shaking hands
• Hugs or kisses
• Coughs or sneezes
• Food or water
• Sharing eating utensils
• Breastfeeding

Hepatitis B is diagnosed with a blood test. This blood test can reveal if an individual currently has hep B, has had hep B in the past (resolved) or has previously received the vaccine. Most tests are accurate within four weeks of exposure but some people may take as long as 3 to 6 months to test positive. You may be encouraged to return for repeat testing.

Your body may clear the virus on its own without treatment within the first 6 months: the majority of adults are able to clear the virus and develop lifelong immunity. However, the majority of infants and children who contract hep B will develop chronic hep B.

• There is no cure for hep B but there are treatment options that can help prevent further damage to your liver.
• To reduce the risk of passing the hep B virus on to your baby, you doctor will ensure that your baby receives an immune globulin injection and hep B vaccine at birth
• Your healthcare provider or public health nurse will provide you with resources, counselling, support, and information to help guide your care, including linking you to community services and/or social workers.
• Your healthcare provider or a public health nurse will help you notify household contacts, sexual and/or drug-equipment sharing partners to encourage them to be tested for hep B, assess their immune status and/or provide vaccine protection to those who are not immune. They can get free hep B vaccination through Ottawa Public Health (OPH).

• Decrease or eliminate alcohol, drug and/or tobacco use
• Get vaccinated for hep B
• Talk to your healthcare provider/pharmacist before starting new medications or natural remedies

• Use an internal or external condom, every time you have vaginal and/or anal sex
• Use water-based or silicone-based lubricants
• If you share sex toys, cover the toy with a condom and clean after each use
• Get tested for sexually transmitted infections (STIs) regularly

• Use new equipment every time you inject, including needles, syringes and all other supplies (like cookers, filters and water)
• Never share equipment with anyone, including your sex partner(s)
• Access Needle and Syringe Programs or Supervised Consumption Services for new equipment and harm reduction services