Hepatitis B

Hepatitis B is a liver disease caused by a very contagious virus. Hepatitis B is a very serious STI. It is more contagious than HIV and can be transmitted through blood and sperm, among other things. An infection with the Hepatitis B virus can lead to severe health problems. Many people do not realise they have been infected, because they don't have any symptoms or health problems. But even when you don't have any symptoms, you will still be very infectious for others.

There are two forms of Hepatitis B: an acute form and a chronic form. With an acute Hepatitis B infection, your body will usually eliminate the virus on its own, without the help of medications. If tests have shown that you have an acute infection, notify all your sex partners from at least the past six months. It you have a chronic infection, notify all your sex partners from even further back in time.

Like Hepatitis A, Hepatitis B is an STI that you can protect yourself against by getting vaccinated. The Hepatitis B vaccination is free at the GGD for men who have sex with men and can be done anonymously.

How do you get Hepatitis B?

Hepatitis B is transmitted through:

  • being in contact with blood, sperm and precum (preseminal fluid), but also by being in contact with urine, shit, spit, sweat and/or tears if any of those contain visible traces of blood.
  • fucking without condoms
  • dry fucking (superficial contact between penis and anus)
  • sharing sex toys 
  • fisting without gloves and without disinfecting the arm in between partners
  • rimming (ass licking)
  • giving blow jobs and tongue-kissing if the mucous membranes in your mouth are damaged
  • sharing needles and/or any instruments used to prepare, snort or anally introduce drugs
  • sharing toothbrushes or razors

Please note: Kissing (including tongue kissing) and drinking out of the same glass are both safe as long as there is no blood in anyone's spit.

Acute and chronic Hepatitis B

There are two forms of Hepatitis B: an acute form and a chronic form.

  • Acute Hepatitis B corresponds to the initial phase of an infection with the Hepatitis B virus. This phase can last from several weeks to six months. In this phase you are highly contagious for others. An acute Hepatitis B infection will usually heal on its own. If that happens, you will no longer be able to transmit the virus to others.
  • If you have chronic hepatitis B, that means that the virus did not heal on its own. In that case, the virus will remain in your blood and in your sperm and precum (preseminal fluid), as well as in all your other "bodily fluids" if those contain traces of blood. That means that you will be a "carrier" of the virus and you can pass it on to others, potentially without even knowing it. Chronic Hepatitis B may have few if any symptoms for a long time. The only way to find out if you have Hepatitis B is to have a blood test done.

It is impossible to predict how the disease will run its course. Symptoms may appear a few months after infection, but sometimes there will be no symptoms at all.

Symptoms of an acute Hepatitis B infection

Many people get no symptoms at all, but if any do appear, the following symptoms are the most common:

  • (severe) fatigue
  • nausea
  • vomiting
  • fever
  • pain in your muscles and joints 
  • a loss of appetite
  • itchiness
  • stomach problems
  • jaundice (yellow skin and eyes, sometimes dark urine and grey shit)

In severe cases, sudden liver failure can occur, although that is quite rare. If that does happen, the inflammation due to the Hepatitis B virus will have damaged your liver cells to such an extent that your liver can no longer function properly.

Please note: even if you don't notice anything of an acute infection with Hepatitis B, it can still seriously damage your health. And you are also highly contagious for others in that period.

Damaging for the liver 

Chronic Hepatitis B can severely damage your health in the long term. The inflammation can scar your liver tissue and may even cause your entire liver to shrivel up (cirrhosis). Cirrhosis of the liver is a serious condition. If your liver is damaged, drinking alcohol can make it even worse. After many years, chronic Hepatitis B sometimes leads to liver cancer.

Notifying your sex partners

If you have Hepatitis B, it is important that you notify your sex partners about that. In the case of an acute Hepatitis B infection, notify all your partners from the past six months. If you have a chronic Hepatitis B infection, notify your partners from even further back (all the way back to whenever you were probably infected). Discuss this with your internist.
If you have Hepatitis B, it would make sense for your steady sex partner(s), your family members and any flatmates you have to get themselves vaccinated against Hepatitis B.

Other STIs

If you have sex with other men, you are advised to get vaccinated against both Hepatitis A and Hepatitis B. Have you ever been infected with Hepatitis B but have you never been vaccinated against Hepatitis A? In that case, your internist will advise you to get vaccinated against Hepatitis A as soon as possible.

If you go to get vaccinated and you find out that you currently have an acute infection with Hepatitis B, it is extra important to get checked once again for all other STIs, but especially for HIV and syphilis. There is a chance that you also got these STIs along with the Hepatitis B.

Spontaneous healing and recovery

In more than 95% of adults, a Hepatitis B infection will heal itself. This happens during the acute phase (i.e. within half a year). Having a healthy diet and a healthy lifestyle will help you recover more easily. It is better not to use any alcohol until you are fully recovered. If you do manage to recover from Hepatitis B, you can never be reinfected with it in the future. You will have become immune to it.

Prevent Hepatitis B: get vaccinated for free at the GGD.

Condoms help to prevent Hepatitis B, but unfortunately they do not offer complete protection against it since Hepatitis B can also be transmitted in other ways. Only the vaccination gives you full protection. The protection you get from being vaccinated will probably last for the rest of your life.

The vaccination shots against Hepatitis B are free at the GGD for men who have sex with men. The vaccination consists of three shots over a period of six months.

Obligatory reporting

If you have Hepatitis B, your doctor and the laboratory are required to report that to the GGD's Department of Infectious Diseases. A "social nurse" from the GGD will contact you and invite you to come round for a consultation. The consultation will cover the following topics:

  • monitoring and possibly also treating your Hepatitis B infection (by a specialist)
  • preventing the transmission of Hepatitis B to others
  • notifying your sex partners
  • getting your flatmates and partners vaccinated against Hepatitis B

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Preventing Hepatitis B

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