Part I discussed how hepatitis B is transmitted and may have helped you determine how you were infected with HBV. In Part II below we will discuss the people closest to you who may be susceptible to your infection.
Anyone exposed to HBV is susceptible. This is especially true if they have not already been vaccinated, or are not taking precautions. HBV does not discriminate. However, those most susceptible to infection are your sexual partners, close household contacts or family members. Why are the these people more susceptible? Remember that HBV is transmitted through blood and infected body fluids, so sexual partners will be at risk. Unfortunately even close contacts without sexual intimacy will also be at risk. These include family members or roommates that might borrow your razor, the nail clippers on the downstairs counter, or your favorite pair of pierced earrings. Such personal items may have microscopic blood droplets on them. Hepatitis B is a tenacious virus that can live outside the body for a solid week. It just makes sense that the odds of an exposure will happen with someone you live with just due to the increased potential for daily exposure in simple grooming routines or household activities.
It is also important to know that unvaccinated babies and young children are more susceptible to HBV. This is because they have undeveloped, immature immune systems. In fact 50-90% of children infected with hepatitis B (the younger the child, the higher the risk) will have life-long infection. That is why hepatitis B vaccination is so important for babies and young children.
So what should you do? You need to do the right thing. You need to talk to sexual partners and close contacts and family members now that you know you are infected. You don’t need to tell everyone; just those that you believe are at risk. Tell them to ask their doctor to run a hepatitis B panel.
The hepatitis B panel is one blood test with 3 parts: HBsAg – surface antigen; HBcAb – core antibody; and HBsAb – surface antibody. When read in combination, this one test can tell your close contacts if they are currently infected, have resolved a previous infection, and whether or not they have immunity to the hepatitis B virus. Typically the blood test results are straight forward, but sometimes they can be tricky. Ask those tested to discuss their results with their doctor, and to keep a copy of the blood tests results for review.
One important factor for those that may have been exposed is the timing. There is up to a 9 week window period between an exposure to HBV and when the hepatitis B virus shows up in the blood resulting in a positive test result. If you tell your partner and they insist on immediate testing, they need to understand that they will need to be re-tested 6 weeks later to ensure whether or not they have been infected. AND, it is essential to practice safe sex and follow general precautions until everyone is sure of their status –both the known and potentially infected.
Remember you may still be in a waiting period trying to determine if you are acutely or chronically infected. Very possibly you have not had symptoms with your HBV. Nearly 70% of those with newly infected with HBV have no notable symptoms. It’s also very likely you are unsure when you were infected. And of course it’s possible you are chronically infected and have had HBV for quite some time. It’s stressful and little confusing not knowing the details of your infection, but you need to move forward doing the right thing and talking to those at risk and taking care of yourself.