Hep B Blog

Category Archives: Relationships

Your Sexual Health and Hepatitis B!

September is Sexual Health Month! This month we focus on the intersection of hepatitis B and sexual health.

Hepatitis B is the most common serious liver infection in the world with 300 million people chronically infected. It is caused by the hepatitis B virus that attacks and injures the liver. Hepatitis B can be spread through sexual contact. It is usually spread when blood, semen, or other body fluids from a person infected with the hepatitis B virus enter the body of someone who is not infected. In fact, hepatitis B is easily spread through sexual contact as it is 50x-100x more infectious than HIV.

Can I Kiss My Partner?

Yes! Spreading hepatitis B through kissing is highly unlikely, however, deep kissing that involves the exchange of large amounts of saliva might result in infection if there are cuts or abrasions in the mouth of the infected person, especially if they have a high viral load.

Does Type of Sexual Activity Matter?

Certain sexual activities are riskier at spreading hepatitis B than others. Oral sex appears to have a lower rate of hepatitis B transmission than vaginal sex. Anal sex carries a high risk of transmission because tears in the skin that can occur during penetration improves the transmission of hepatitis B.

Who Should be Vaccinated for Hepatitis B?

The great news is that there is a safe and effective vaccine for hepatitis B and is recommended for sexually active adults. Once vaccinated, a person should be protected from developing a hepatitis B infection even if they are exposed through sexual contact! Adults who especially should get the vaccine include:

  • People with multiple sexual partners
  • Anyone who has been diagnosed with a sexually transmitted disease
  • Men who have sexual encounters with other men
  • Sexual partners or close household contacts of someone living with hepatitis B

For adults, the vaccine is usually given as a series of 3 shots over a period of 6 months. In the U.S., there is also a 2-dose vaccine available that is given over 1 month. Whichever brand of vaccine you take, the entire series of shots is needed for long-term protection. If you are unaware of your hepatitis B status, ask your healthcare provider to get tested! More information on the simple hepatitis B testing can be found here!

Additional Prevention Methods

Practicing safe sex is also a great way to prevent the transmission of hepatitis B. If someone is living with hepatitis B and you don’t know your partner’s hepatitis B vaccine status, be sure to have sex with a condom to prevent the transmission of hepatitis B during intercourse. Sometimes during sex, people like to use personal lubricants. When using condoms it is important to remember to only use silicone or water-based lubricant. Oil-based lubricants increase the chance of ripping or tearing the condom.

 

Author: Evangeline Wang

Contact Information: info@hepb.org

Sexual Transmission and Hepatitis B Among Adults in China

As the birth-dose for hepatitis B (HBV) increases, sexual transmission is the most common mode of transmitting hepatitis B among unvaccinated adults. A research study, “Evaluating the independent influence of sexual transmission on HBV infection in China: a modeling study” evaluated the independent impact of sexual transmission on hepatitis B. This blog will give a summary of the results of the study, prevention tips, and future recommendations.

Summary of Research Study

 The researchers of this study developed an age- and sex-specific discrete model at the population level to evaluate the influence of sexual transmission on HBV infection in China. They found that in 2014, due to sexual transmission, the total number of chronic HBV infections in people aged 0–100 years increased by 292,581 people! That year, due to sexual transmission, there were  189,200 new chronic infections among men and 103,381 new chronic infections among women. In 2006, sexual transmission accounted for 24.76% (male: 31.33%, female: 17.94%) of acute HBV infections in China and in 2014, sexual transmission accounted for 34.59% (male: 42.93%, female: 25.73%) of acute HBV infections in China. These statistics demonstrate that acute HBV infections due to sexual transmission increased by 10% and 8% respectively from 2006-2014.

However, researchers found that if the condom usage rate increased by 10% annually starting in 2019, then compared with current practice, the total number of acute HBV infections from 2019 to 2035 would be reduced by 16.68% (male: 21.49%, female: 11.93%). The HBsAg prevalence in people aged 1–59 years in 2035 would be reduced to 2.01% (male: 2.40%, female: 1.58%).

Prevention and Harm Reduction Strategies During Sex

 Practicing safe sex is can be a great way to prevent the transmission of hepatitis B. Condoms are an effective way to prevent the transmission of hepatitis B during intercourse. Sometimes during sex, people like to use personal lubricants. When using condoms it is important to remember to only use silicone or water-based lubricant. Oil-based lubricants increase the chance of ripping or tearing the condom. It is highly recommended if someone is living with hepatitis B to have sex with a condom, however, if you are having sex without a condom, certain sexual activities are far more efficient at spreading hepatitis B than others. Oral sex appears to have a lower rate of hepatitis B transmission than vaginal sex. Anal sex carries a very high risk of transmission because tears in the skin can occur during penetration, allow more transmission routes for the virus.

Recommendations

If you have never been vaccinated for hepatitis B, it is recommended that you receive the vaccination. The hepatitis B vaccine is a safe and effective vaccine that is recommended for all infants at birth and for children up to 18 years. Since everyone is at some risk, all adults should seriously consider getting the hepatitis B vaccine for lifetime protection against preventable chronic liver disease. The hepatitis B vaccine is also known as the first “anti-cancer” vaccine because it prevents hepatitis B, the leading cause of liver cancer worldwide.

If you think you might be at increased risk for hepatitis B infection, is also recommended you get tested for hepatitis B. Hepatitis B is known as the” silent” infection, meaning you could be infected with the virus and not show symptoms that can cause long-term liver damage. If you have not been tested for hepatitis B and would like to know your status, you should get in contact with your primary care provider. Your physician should order a panel of three blood tests for the hepatitis B panel:

  1. HBsAg (hepatitis B surface antigen)
  2. Anti-HBs or HBsAb (hepatitis B surface antibody)
  3. anti-HBc or HBcAb (hepatitis B core antibody)

The results of all 3 blood test results are needed in order to make a diagnosis. Be sure to request a printed copy of your blood tests so that you fully understand which tests are positive or negative, and what your hepatitis B status is.

If you know you have had unprotected sexual intercourse with someone living with hepatitis B, there is something called post-exposure treatment. If an uninfected, unvaccinated person – or anyone who does not know their hepatitis B status – is exposed to the hepatitis B virus through contact with infected blood, a timely “postexposure prophylaxis” (PEP) can prevent infection and subsequent development of chronic infection or liver disease. This means a person should seek immediate medical attention (within 72 hours of exposure) to start the hepatitis B vaccine series. In some circumstances, a drug called “hepatitis B immune globulin” (HBIG) is recommended in addition to the hepatitis B vaccine for added protection.

 

Author: Evangeline Wang

Contact Information: info@hepb.org

Hepatitis B and Stigma

 

Hepatitis B and Stigma

World Kindness Day is just around the corner on November 13th. On World Kindness Day, we celebrate kindness and spread it around the world. Let’s celebrate this day by treating people living with hepatitis B with kindness, compassion, and respect.

Unfortunately, hepatitis B is often highly stigmatized – and the people living with it can feel ostracized. Why is there so much stigma surrounding hepatitis B? A study found that among Asians, the majority thought hepatitis B was a genetic disease which is why the family might feel stigmatized if a family member is living with it.1 Due to cultural values, interdependence, collectivism, and family centeredness, persons of Asian descent might think that having hepatitis B is a reflection on the family.1 This attitude could lead to people not wanting to get tested for hepatitis B because they worry about bringing stigma to the family.1 Another study found that among African communities, individuals were confused about the differences between hepatitis B, HIV, malaria, and other infectious diseases.2 This misattribution and confusion could lead to a person living with hepatitis B being perceived as an outsider to society and can cause stigma or discrimination.2

The studies demonstrate that the lack of education and information surrounding hepatitis B contributes to the stigma that individuals living with hepatitis B face. There is a lot of ignorance, myths, and misconceptions about hepatitis B. Let’s debunk some of these notions!

Hepatitis B cannot be spread through casual contact, only through blood-to-blood contact or sexual transmission. This means you can hug, kiss, and share a meal with your friends and family without worrying about contracting hepatitis B. In Asian communities, it is especially important to emphasize that family members living with an individual who has hepatitis B, can share meals with each other. And there is a safe and effective vaccine to protect loved ones – so transmission can be prevented!

Sometimes people do not want to discuss their hepatitis B status because of its association with intravenous drug use. People who inject drugs experience more discrimination because of the stigma surrounding addiction. On the flip side, individuals who do not inject drugs but are living with hepatitis B, might not want to discuss their status for fear that other people will stigmatize or label them as drug users. Additionally, people might assume individuals living with hepatitis B engage in risky sexual behavior which can further stigmatize them. This stigmatization only harms people living with hepatitis B because they cannot talk about their status openly, which would help destigmatize the disease.

Even extending past World Kindness Day, we encourage you to be kind to people living with hepatitis B. And if you are living with hepatitis B, please be kind to yourself! Continue to educate yourselves on hepatitis B to help lessen the stigma and discrimination surrounding it.

Below is a brief list of resources for people living with hepatitis B or individuals living with people living with hepatitis B.

  1. Transmission of hepatitis B – how hepatitis B can be transmitted
  2. Online Support Groups
  3. Factsheet – When Someone in the Family has Hepatitis B
  4. Know Your Rights – for anyone experiencing discrimination because of their hepatitis B status

References

  1. Kim, M. J., Lee, H., Kiang, P., Watanabe, P., Torres, M. I., Halon, P., Shi, L., & Church, D. R. (2015). Debunking the myth: low knowledge levels of HBV infection among Asian American college students. Asia-Pacific journal of oncology nursing, 2(1), 8–16. https://doi.org/10.4103/2347-5625.152399
  2. Mokaya, J., McNaughton, A. L., Burbridge, L., Maponga, T., O’Hara, G., Andersson, M., Seeley, J., & Matthews, P. C. (2018). A blind spot? Confronting the stigma of hepatitis B virus (HBV) infection – A systematic review. Wellcome open research, 3, 29. https://doi.org/10.12688/wellcomeopenres.14273.2

Author: Evangeline Wang, Program Coordinator

Contact Information: info@hepb.org

National Family Caregivers Month and Hepatitis B

November is National Family Caregivers Month! There are over 40 million Americans who are unpaid caregivers to their families, friends, and neighbors1. This month we celebrate and support all the caregivers who work tirelessly to keep our family and communities strong.

Caregivers and Hepatitis B

 Caregiving can be a tough, but noble job. It is often unpaid, long hours, and can cause burnout. However, caregivers selflessly work to provide their friends or family with the best care possible. Hepatitis B just does not affect the person living with the virus; it affects their family, friends, coworkers, and community members. Someone who lives with an individual who has hepatitis B might be put in a caregiver position.

Caring for an individual living with hepatitis B might be difficult if the person has advanced liver disease or is experiencing side effects from medication. While it may not always be physically demanding, caring for a person with hepatitis B can be emotionally overwhelming. Caring for an individual living with hepatitis B and other related complications can stir up heavy emotions which can take a toll on a caregiver’s mental health. Managing medications, diet, and healthy lifestyle for people living with hepatitis B during the COVID-19 pandemic can especially feel stressful. Luckily, there are resources available to help reduce feelings of stress and being overwhelmed.

Resources for Caregivers

Feeling stressed or overwhelmed with taking care of your friend or family member? It is also important to look after your own physical and mental health. Check out these resources from the How Right Now Initiative to help you manage your stress especially during COVID-19. Some suggestions include:

  1. Go for a quick walk or stretch
  2. Call, text, or video chat with friends or family
  3. Take several deep breaths

Does someone in your close circle have hepatitis B? Check out the Centers For Disease Control and Prevention’s Know Hepatitis B Campaign’s fact sheet, When Someone in the Family has Hepatitis B”. This fact sheet has basic information about hepatitis B and the importance of testing and vaccinating family members. The fact sheet is available in 13 Asian and African languages as well as three English versions focused on Asian American, Native Hawaiian and Pacific Islander, and African Immigrant communities. Download the fact sheet here.

For more information about the Know Hepatitis B Campaign, visit the campaign website.

References

  1. https://www.whitehouse.gov/presidential-actions/proclamation-national-family-caregivers-month-2020/
  2. How Right Now Initiative
  3. CDC’s Know Hepatitis B Campaign

Author: Evangeline Wang, Program Coordinator

Contact Information: info@hepb.org

I Have Hepatitis B; Can I Get Married?

At the Hepatitis B Foundation, we answer thousands of calls, social media messages, and emails a year from individuals affected by hepatitis B. One of the most common questions we receive is: If I have hepatitis B, can I still get married? 

To put it simply, yes, a person living with hepatitis B can get married. In fact, a healthy relationship can be a source of love and support for those who may feel alone in their diagnosis.

Transmission of hepatitis B can be prevented in your partner; it’s a vaccine preventable disease! Keep in mind that hep B is common in many parts of the world. When properly tested, people often learn they too are living with chronic hep B or that they have recovered from a past infection. A hepatitis B triple panel blood test (HBsAg, HBcAb total and HBsAb) will let your partner know if they have a current infection, have recovered from a past infection and whether or not they need to be vaccinated.  Future children should also be vaccinated starting as a newborn to help prevent transmission, especially if the mother is hepatitis B surface antigen positive (HBsAg+)!

If your partner is waiting for the vaccine or is unable to be vaccinated for some reason, there are other precautions that one can take to prevent transmission: practice safe sex by using a condom, properly wrap all wounds, clean up any spilled blood with gloves and a fresh solution of 1 part bleach to 9 parts water, and don’t share sharp personal items (razors, toothbrushes, nail clippers, and body jewelry). This list may seem like a lot, but they are mostly things that we do every day without thinking much about it! 

Physically, there are no barriers that prevent an individual living with hepatitis B from getting married. The question often stems from a place of fear that is fueled by the stigma and discrimination around them. Oftentimes, we give fear too much power in our lives. It can control our actions and cause us to isolate ourselves. It’s important to remember that an individual is not their diagnosis. The essence of who you are as a person has not changed! 

Many of our #justB storytellers are leading happily married lives with supportive spouses who help them maintain a healthy lifestyle. Chenda was already engaged when she first discovered that she was living with hepatitis B. She said, “ When my fiance called, I was scared to answer but I told him the truth. He said ‘I love you’ and encouraged me to see a doctor”. Chenda and her husband now have a baby who they made sure was protected from the virus! Another storyteller, Heng, shares how he felt when the woman he was in love with told him that she was living with hepatitis B. After she told him, he got tested and found out he was already protected due to the vaccine! They later married and had children. “We make better lifestyle choices because of her illness, but we don’t let it define our lives”. 

Hepatitis B is not a weakness. Each day, millions of people living with chronic hepatitis B make the choice to wake up and live life to the fullest. Like many others, Edwin – one of our new #just B storytellers – was surprised by his diagnosis. Instead of letting it hold him back, he decided to show the world how strong he was by competing in a series of rigorous athletic competitions to set an example for others like him. “I want to show that Hepatitis B is not a condition that debilitates someone,” said Edwin.  “We can triumph through adversity.” 

Our #justB storytellers are examples of hope, inspiration, and strength; they are people living their truths.They also remind us that the difficulties that we face in life can make us stronger as a person. Despite the fear that Bright felt, he persevered and took action. “Slowly I started to have days when I wasn’t hopeless, when I could face the unknown. I talked to my doctors, did my own research, and made my own decisions….Now I realize I have changed: I am more resilient than ever before.”

If I Have Hepatitis B, Why Doesn’t My Partner?

Why do some people — who were not vaccinated — never get hepatitis B from their sexual partners? The question is a common one.  As a sexually transmitted disease, it may seem obvious that your partner may contract hepatitis B from their partner, especially if you have been together for some time.

It comes down to factors, such as the type of sexual activity you engage in, the viral load (HBV DNA) of the infected partner, and who is on the receiving end of infectious body fluids, especially blood that contains the most virus, and semen.

Having one partner infected, while the other is not, can add more

stress to an already traumatic hepatitis B diagnosis. “It was very confusing and made me question how was it possible I was the only one infected,” said a woman who tested positive while her husband tested negative.  “I thought it was possibly a mistake, maybe I was a biological anomaly, which of course I was not.”

Let’s look at the factors that affect who gets infected and who doesn’t when two people have sex.

Viral load: Semen, vaginal fluids and blood all contain the hepatitis B virus (HBV), and the higher the viral load, the more infectious a person is considered to be. However, having an undetectable viral load doesn’t mean you won’t infect someone during unsafe sex. Even if a man has an undetectable viral load, studies show his semen still contains some of the virus and can spread infection, though the risk is lower.

Essentially, if a man tests positive for the hepatitis B surface antigen (HBsAg), he must consider himself infectious.

The role of gender: In heterosexual relationships, uninfected women are at higher risk of getting infected by a male partner infected with hepatitis B, rather than the reverse. Women are on the receiving end of semen, which greatly increases their risk of becoming infected unless a condom is used.

When a woman is infected with hepatitis B, an uninfected man is at risk through direct contact with her vaginal secretions, but that contact is lower-risk than a woman’s direct exposure to infectious semen during intercourse.

However, an infected woman who is menstruating is more likely to spread hepatitis B because blood can contain higher levels of HBV than vaginal secretions. That is why gloves and dental dams are recommended to provide a barrier against exposure.

The type of sexual activity: Certain sexual activities are far more efficient at spreading hepatitis B than others. Oral sex appears to have a lower rate of hepatitis B transmission than vaginal sex. Anal sex carries a very high risk of transmission because of tears in the skin that can occur during penetration, which improves transmission of HBV.

Fingering carries a lesser risk, unless the infected woman is menstruating or a person has bruises or cuts on their hands that allow entry of hepatitis B virus from the body fluid into the bloodstream.  In such cases, gloves are recommended.

The “uninfected” partner could already have been infected and cleared hepatitis B: When a person is first diagnosed with hepatitis B, doctors often test his or her partner for only the hepatitis B surface antigen (HBsAg), which indicates a current hepatitis B infection. If they are negative for HBsAg, they are immediately vaccinated. However, this does not mean that they were never infected.

If the partner isn’t also tested for the hepatitis B surface antibody (anti-HBs or HBsAb), then no one knows if the individual was already protected, either due to recovery from a past hepatitis B infection or because they had already been vaccinated.

Hepatitis B is not called the “silent” infection for nothing — many people who get hepatitis B never have any symptoms and never realize they were infected. As a result, a wife, husband, partner or lover who tested negative for HBsAg, may actually have been

infected in the past and cleared the infection and now has protective hepatitis B surface antibodies to forever safeguard them from infection. If they’re immediately vaccinated and retested after the three-dose vaccination, they will test positive for surface antibodies, without ever knowing that their antibodies resulted from a past infection, not immunization.

Bottom line, if one of you have been diagnosed and the other is not infected, it is unusual but not uncommon. Get tested using the 3-panel blood test (HBsAg, HBsAb, and HBcAb) and immediately vaccinated if the uninfected partner tests negative for the hepatitis B surface antibody (HBsAb).

Take a quiz to find out how much you know about hepatitis B transmission: click here.

Patient Perspective: Living with Chronic Hepatitis B & Fighting it On All Fronts

 

This post is by guest blogger Mariam. Mariam works at a charity cancer hospital and is interested in philosophy. She is currently learning french and enjoys spending time by herself and the mountains. 

When you are first told that you have a chronic disease that is treatable but has no cure, you are suddenly confronted with an enemy on multiple fronts—you have to fight it within your body, inside your mind, your heart and in the outside world. Chronic hepatitis B: nearly 15 million people are living with it in Pakistan. In the world, 292 million people are silently suffering from this , and most are unaware (which is 9 out of 10 people globally). It is a tragedy that 2 out of 3 liver-related deaths are caused by this infection which is preventable and treatable. There are many reasons why this disease is prevalent in a developing country like Pakistan that lacks a proper healthcare system; where there are no pregnancy screenings or an effective mechanism to ensure babies are vaccinated against this. It’s an infection that can be transferred through blood (most commonly from an infected mother to her baby during delivery)  and sexual intercourse and  so it is not difficult to understand how this disease travels from one generation to another, silently. Elimination of viral hepatitis by 2030 is one of the millennium goals of the World Health Organization, but we cannot achieve this without dedicated efforts by all the stakeholders that include health-care professionals, patients, media, and policy-makers. I am primarily interested in sharing the patient’s perspective, in hopes that it will encourage others to fight this epidemic.

A Patient’s Point of View

The fact it’s a chronic illness means you are in for the long haul and you have to be prepared to take care of yourself by regular monitoring/medications (depending on what stage you are at) for the rest of your life. One can argue that’s bad but it’s not a big deal as we have people who suffer from high blood pressure, bad eyesight, or diabetes and they also have to regularly take care of themselves. The problem is that hepatitis B is an infectious disease, a fact that contributes towards stigma surrounding its diagnosis. Suffering from flu makes me feel like a hazard to others. Having an infection that I cannot get rid-off certainly makes me feel bad and, in a way, dirty. I have to be cautious and aware that my blood is hazardous for others and I have to be constantly aware of all the possibilities I can be harmful and ways to prevent it. It’s a progressive disease which can be treated at a certain point, so when you go to follow-up appointments, you feel like a ticking bomb is inside you and you need to be able to identify the period when the bomb goes off so you can treat the damage. Because current hepatitis B medications are most effective when there are signs of liver damage, the treatment is often only given during this phase. The inherent uncertainty makes you hate hepatitis B.

Fighting Discrimination and Stigma

Living in a conservative society, if you are one of the few fortunate ones aware of your diagnosis, how do you deal with it? I kept it to myself because I did not want people to define me through my illness. I did not tell my parents or friends because I did not want them to see me as ill or worse, to pity me. I needed time to process it without having to deal with other’s opinions and judgments. Three years ago, I was diagnosed with hepatitis B during regular pre-employment screening. I did not even know anything about this disease. I had a biopsy to determine the stage of the disease. Then I went to a few follow-ups. Unfortunately, after a while, I stopped because I did not want to think about this illness. I wanted to forget about it so I tucked it away, in the farthest corner of my mind. I did not know many people with whom I felt safe talking about this. Until one day, I was at a fundraising event for a charity cancer hospital where I got the chance to sit with a doctor. He was a stranger and a doctor, so in a way I felt safe telling him why I’m so interested in trying to understand where my country stands in the fight against hepatitis B—I told him I was diagnosed with it. At one point he asked me if I’m on treatment,  and I honestly told him I am supposed to be on follow-up. He said, “What do you mean, supposed to be?” That slight hint of disappointment made me feel I failed in taking care of myself. It’s easier to sound irrational inside your head but when you share it out loud, it does not feel nice. He told me that first, I need to sort out myself before trying to make a difference in the world of hepatitis B. I am grateful for the brief discussion with him which gave me the courage to think about re-scheduling my long overdue follow-up appointment. It gave me the clarity that I wanted to share my story with others in hopes that those who are fighting hepatitis know they are not alone. Sharing my story also helps me feel that I am not alone either.

I feel it is very important to fight the stigma surrounding hepatitis. Only then we will be able to talk about it and bust the myths. Only then we will be able to discuss ways to fight it on the ground. It is common in a conservative society to put a label on you as defective and exclude you from everything. For instance, marriage is still, by large, the union in this culture after which people have sexual intercourse and have kids; both occasions that can be possible causes of transmission of this virus. If, before marriage, a person is aware of their diagnosis, they can ensure that their partner is vaccinated and safe. However, in this society, there is also a prevalent culture of arranged marriage which makes this whole discussion almost impossible because so-called “perfection” is demanded. I wonder if submitting your hepatitis status with a marriage certificate was compulsory, would it help in data collection and early detection of this disease or would it encourage stereotyping. What if it was possible to vaccinate every child who starts school to be vaccinated against hepatitis B? After all, mandatory vaccinations are common in other countries. But what about children who can’t afford to go to a school? Can we link hepatitis B vaccination confirmation mandatory with every birth certification? This works in many other countries that vaccinate every baby born – we need to able to fight hepatitis B with a strong response such as this.

I also have an obsession with trying to understand this virus that is sharing my body. So my brain imagined a story to help understand how the chronic hepatitis B works. There are the good guys (liver cells) and bad guys (virus) who grew up together quite happily. Until one day, the good guys realized that these other guys are not from amongst us, let’s kill them. There is a battle and then there is collateral damage. What I want to understand is, if the bad guys aren’t harming the good guys, then why does the body start fighting them? And what is the purpose of their existence if they are not bad guys by default? Perhaps one day someone will help answer my questions. Until then, I’ll try to focus on the inevitable fight.

 

Valentine’s Day: Dating, Love, and Hepatitis B

Valentine’s Day is a day of celebration, but it can also bring about worries and stress. Some might feel pressure about buying the right gifts for their loved ones. Maybe you’re wondering if it’s too soon in your relationship to celebrate the holiday. We may not be able to help you figure out what type of candy your partner likes the most, but we can help you navigate the holiday if you or a loved one is living with hepatitis B!

Can my partner and I have sex if one of us is infected and the other is not?

One way that hepatitis B is spread is through unprotected sex. This means that certain precautions need to be taken if your partner is uninfected, has not been vaccinated, or has not completed their vaccine series yet. Precautions include using a condom correctly. Using condoms can also prevent other sexually transmitted infections, like hepatitis C and HIV, that can be harmful to everyone, but especially to those who have chronic hepatitis B. Please keep in mind that certain sexual activities carry higher risks of transmission because of tiny, often microscopic tears in the membrane that may occur and increase the chances of direct blood contact! If you believe your partner has been accidentally exposed, they should contact their doctor or a local physician to begin post-exposure prophylaxis (PEP) as soon as possible. PEP can prevent chronic hepatitis B if caught early enough, so it is very important to inform the doctor of a possible exposure soon after it occurs.

If your partner has already completed the 2 dose (where available) or 3 dose vaccine series, there is nothing to worry about! They are not at risk for transmission! The recommended schedule for the three-dose vaccine consists of a dose at 0, 1 and 6 months, and the two-dose adult vaccine is at 0 and 1 month.  Some individuals may be interested in an accelerated vaccine schedule. Please understand that an accelerated schedule entails four shots, not three. The fourth shot would be administered at one year and would provide long term protection. Those that choose a shortened schedule will not have long term protection from hepatitis B if they do not complete the fourth dose. And your partner should have their blood tested 4 weeks after their last vaccine dose to confirm that they are protected.

I’m scared to tell my partner that I have hepatitis B.

It can be intimidating to tell a person something so personal, especially if you are uncertain about how they will react. However, it is extremely important! Even if you are using condoms, it is necessary to let your partner know your status before becoming intimate. Once you tell them, it will be a huge relief!

So, how can you prepare for the conversation?

  1. Research: hepatitis B can be confusing, so it is important that you both are familiar with the infection, including how it is transmitted! Apart from HBF’s website, the Centers for Disease Control and Prevention (CDC) has great information and handouts (in multiple languages!) on the infection. Consider printing one or two fact sheets out for your partner to look over.
  2. Take a deep breath: Don’t rush into the conversation. Take a moment to think about what you want to say. This will help you to stay calm and allow the conversation to progress. Remember to let your partner talk as well!
  3. Speak confidently: Don’t let hepatitis B speak for you! Let your partner know what you’ve learned about your infection and inform them that you are regularly visiting the doctor to monitor the infection. Speaking confidently can help keep them calm as well, and assure them that there is nothing to worry about!

If they react badly to the news at first, don’t worry! Everybody processes things at different rates and many people fear what they don’t understand. Try giving them some space and let them think about the information they’ve been given. You can also show them Heng’s #justB video; it tells the story of a man who fell in love and married a woman who is living with chronic hepatitis B and how he still supports her today! Also, remind your partner that hepatitis B is vaccine preventable! Three simple shots can protect them for life and they will never have to worry about the risk of transmission again!

Some people will never react kindly to the news, and that’s okay too! It may be disappointing, but don’t let it keep you down! You deserve someone who will accept and love you for who you are! Your chronic hepatitis B infection does not define you; it is just a small part of who you are.

For Partners of Chronic Hepatitis B Patients:

Valentine’s Day is a  time of love, and what better way is there to show love than by being supportive? If your partner is living with hepatitis B, you can show them you care in small ways! Perhaps it’s skipping the alcohol once in a while when you two go out with friends so they don’t feel alone. You can also try cooking healthy meals with them or exercising together a few times a week. Small gestures can say big things!

My partner has been diagnosed with hepatitis B. Can transmission be prevented by vaccination?

Courtesy of Google Images

A hepatitis B diagnosis can be scary and confusing for both you and your loved ones, especially if you are unfamiliar with the virus. Hepatitis B is known to be sexually transmitted, and you may wonder how you can continue your relationship with someone who has been infected. The good news is that hepatitis B is vaccine preventable. This means that after you complete the vaccine series, you cannot contract hepatitis B through any modes of transmission; you are protected for life!

However, it is important to remember that the vaccine will only work if a person has not been previously infected. Therefore, it is necessary to take certain steps after your partner’s diagnosis to protect yourself from becoming infected.

The first step is to visit the doctor and get tested, even if you think that you do not have it. Since hepatitis B often has no symptoms for decades, testing is the only way to know your status. The doctor should perform the Hepatitis B Panel test – a simple blood draw that shows hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb or anti-HBs), and hepatitis B core antibody total (HBcAb or anti-HBc). Looking at these three blood test results together will show if you have a current infection, have recovered from a past infection, or if you need to be protected through vaccination. Once you receive your results, this chart can help you understand what they mean.

Preventing Transmission through Vaccines:

If you test negative for HBsAg, HBsAb, and HBcAb, you are not protected from hepatitis B and are considered to have a high risk of contracting the virus from your partner or other means. To prevent transmission, you will need to begin your vaccination series as soon as possible.

The hepatitis B vaccine is a 3-shot series taken over the span of 6 months. The first shot can be given at any time. The second dose should be given at least one month after the first shot, and the third and final dose should be separated from dose 2 by at least two months and dose 1 by at least 4 months.  While there is a minimum amount of time required between doses, there is no maximum amount of time. If you miss your second or third shot, you do not have to start the series over again; you can pick up where you left off! If your partner is pregnant and was diagnosed with hepatitis B, extra precautions need to be taken to prevent transmission to the child. Two shots will need to be given to the child in the delivery room: the first dose of the hepatitis B vaccine and Hepatitis B Immune Globulin (HBIG), if recommended and available in your country.  You can learn more about pregnancy and hepatitis B here.

After completing the series, a quick blood test called the “antibody titer” (anti-HBs titer) test can confirm that you have responded to the vaccine. This test, which should be given at least one month after you receive the third dose, will be greater than 10 mIU/mL if you are protected from hepatitis B. Like the vaccine, your doctor can administer the titer test.

Hepatitis B is spread through direct contact with blood. HBV  is also a sexually transmitted disease, so it is important to practice safe sex by using condoms throughout the duration of the vaccine series until the antibody titer test confirms that you are protected. While you wait for your body to create its defense, there are other steps that you can take to avoid transmission such as not sharing toothbrushes or sharp objects like razors.

The hepatitis B vaccine is the only way to fully protect yourself from the virus. Preventive measures such as using condoms can help prevent hepatitis B transmission, but without vaccination, there can still be some risk.

If you do not have a doctor or are worried about the cost of testing or vaccination, you can still get tested and vaccinated! In the United States, Federally Qualified Health Centers provide the hepatitis B vaccine at low- or no cost to individuals without insurance or with limited plans. You can search for a health center near you here. Internationally, you can search our Physicians Directory and the World Hepatitis Alliance member map to identify member organizations in your country that may have advice on doctors in your area. In addition, keep a lookout out for local health fairs and screenings; they may provide free vaccinations or testing for hepatitis B!