Hepatitis B How do you get it? The hepatitis B virus is in blood, cum, piss, spit and shit, as well as other body fluids of a person who's infected. The virus can be spread by sharing needles, sharing snorting straws, unprotected sex, or by getting blood or other infected body fluids in the mouth, eyes, or on to broken skin. It is much more infectious than hepatitis A, hepatitis C or HIV. How do you prevent it? Using condoms can help prevent many cases of hepatitis B but the best way to prevent infection is by getting vaccinated. The vaccine is available from GUM clinics. The vaccine is a short course of injections taken at set intervals (usually weeks to months between injections depending on what clinic you attend or what is convenient for you). The number of injections you need will depend on your response to the vaccine but expect about three. This is to ensure the vaccine has worked and that you remain immune to hepatitis B. This vaccine is not effective for everybody and some people will not be able to acquire full immunity to the virus. How do you know you've got it?If you catch hep B, you may not show any symptoms, but if you do they can include fatigue, nausea, vomiting, pain in the liver area, dark urine or light coloured shit, and fever. Many adults develop jaundice, which turns their skin and the whites of their eyes a yellowish colour.While most people get over hepatitis B and cease to be infectious, about 10% remain long-term carriers who are able to pass on the infection for many years. Hepatitis B has a long incubation period of one to six months. During this time, a person is infectious although this may not be obvious or easily detectable. When symptoms do appear, they are usually similar to those for hepatitis A. Sometimes, however, the symptoms may be mistaken for flu. Some people who have hepatitis B can remain ill for one to two months, normally without needing hospitalisation. Over years chronic hepatitis B can lead to liver cirrhosis, liver cancer and death.A sexual health clinic can test you for hepatitis B. They will usually ask questions about the sex you've had to see if this test is necessary. It is tested for by taking a blood sample at a clinic or at your GP. Hep B is a common infection in gay men with some long term health effects. It is easily preventable with a course of vaccinations. How do you treat it? Not everybody needs treatment immediately. People who have chronic (more than 6 months) hepatitis B infection should see a specialist and have blood tests and a liver ultrasound scan done. The decision to start treatment is based on these results. There are two types of treatment for hepatitis B. Interferon injections can be given for one year but most people are treated with antiviral medication. These are antiviral tablets that interfere with the virus' ability to reproduce, they are usually recommended in the long term. Some of these drugs are the same as those used to treat HIV. i.e Tenofovir, Lamivudine. Anyone with chronic hepatitis should avoid alcohol. Which sexual partners should I inform if I've been diagnosed with hepatitis B?You should inform anyone you've had sex with, or shared a needle with if you have injected drugs, up to two weeks before any jaundice appeared and up until your blood tests are negative. If you don't have symptoms, it will depend on what stage of hepatitis B you have and the level of risk involved, so talk to your health adviser about this. BACK TO STIS CLINICS AND SUPPORT HOW RISKY IS...?