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Viral hepatitis

Viral hepatitis in gay and bisexual men

What is viral hepatitis?

    • A virus that infects the liver causing inflammation.
    • 3 of these viruses can be sexually transmitted between gay and bisexual men
      • hepatitis B
      • hepatitis C
      • hepatitis A
    • Hepatitis B and C can lead to chronic infection and long term liver damage.
    • We routinely screen all gay and bisexual men for these viral infections.
    • Infection with hepatitis A and B can be prevented through vaccination.
    • Vaccination is provided free through all sexual health clinics.
    • If you are infected with hepatitis B or C we recommend that you should have a full STI screen including an HIV test.

How common is viral hepatitis?

  • Hepatitis B: in the UK it is uncommon in the population as a whole (estimated prevalence 0.3%) but more common amongst gay/bisexual men, intravenous drug users and in ethnic groups from other parts of the world where hepatitis B is common – SE Asia, Africa, Middle and Far East, and Southern and Eastern Europe. In these countries between 5-15% of the population may be infected with Hepatitis B
  • Hepatitis C: in the UK occurs mainly amongst intravenous drug users, people who received blood transfusions prior to 1989 including haemophiliacs and amongst gay and bisexual men
  • Hepatitis A: in the UK it is rare and it is mainly seen in people returning from abroad particularly third world countries. Outbreaks also occur amongst gay and bisexual men.

    How do you catch viral hepatitis?

      • Hepatitis B:
        • through unprotected anal or oral sex and oral – anal contact (rimming).
        • sharing needles or equipment during injecting drug use including ‘slamming’
        • receipt of infected blood or blood products
        • tattooing and body piercing
        • from an infected mother to her baby at birth (in countries where Hepatitis B is common most transmission occurs this way)
      • Hepatitis C:
      • sharing needles or equipment during injecting drug use
      • receipt of infected blood or blood products prior to 1989 in UK (all blood in the UK has been screened for hepatitis C since 1989)
      • tattooing and body piercing
      • sometimes through unprotected anal or oral sex – risk increased if source person is also HIV positive
      • from an infected mother to her baby – risk usually low unless mother also has HIV
      • Hepatitis A
        • through the faecal – oral route (by not washing hands after using toilet and via contaminated food and water)
        • in gay men it can be sexually transmitted through oral – anal contact

    What would I notice if I had viral hepatitis?

      • Acute hepatitis 
        • you may feel generally unwell with a fever, tiredness, loss of appetite, nausea, abdominal pain, jaundice and pale stools and dark urine – you need to seek medical advice.
        • about 50% people do not notice anything wrong – they are infected ‘silently’.
        • after acute infection with hepatitis B or C some people clear the virus from their body but others become chronic carriers.
        • people infected with hepatitis A almost always clear the virus.
      • Chronic hepatitis
        • following acute infection with hepatitis B or C:
          • some people remain infected with the hepatitis virus and become chronic carriers (about 10% of those with hepatitis B and up to 80% of those with hepatitis C) and may pass the infection to sexual partners
          • some people ‘clear’ the virus, will have no further problems and are not infectious to sexual partners
        • people with chronic viral hepatitis usually have no symptoms in the early years so have no idea they are infected.
        • chronic viral hepatitis may lead to serious liver problems after 10 -20 or more years.

    How do I get tested for viral hepatitis?

      • A blood test for hepatitis A, B and C – this will show if you have acute or chronic infection or if you have been infected in the past and since cleared the virus.
      • At the Wolverton we routinely offer screening for hepatitis A, B, and C to all gay and bisexual men.

    How is hepatitis prevented?

      • Hepatitis B: through a course of hepatitis B vaccine – 3 doses over 3 weeks, a booster at 1 year
      • Hepatitis C: no vaccine available
      • Hepatitis A: through a course of hepatitis A vaccine – 2 doses 6 months apart

    Please note we do not offer Hepatitis B vaccinations for travel or occupational reasons, we only provide this for sexual health related matters.

    How is viral hepatitis treated?

      • People may be referred to specialised hepatology services for assessment and possible treatment.
      • Chronic hepatitis C may be cured in most people with a 6 month course of medication that includes tablets and possibly injections.
      • Chronic hepatitis B may be treated and controlled with long term tablet medication but it cannot be cured.

    What about my partner?

      • If you have acute hepatitis (A, B or C) or are a chronic carrier of hepatitis B or C, you may pass the virus to your partner through sexual contact.
      • All partners should be screened for hepatitis A, B and C.
      • All partners should be vaccinated against hepatitis A and B.

    What problems can untreated viral hepatitis lead to?

      • Chronic infection with hepatitis B or C can lead to liver damage with cirrhosis and possibly liver failure and / or liver cancer.
      • Vaccination against hepatitis B can prevent infection and these long term problems.

    Will viral hepatitis come back again after treatment?

      • Cure rates after hepatitis C treatment depend on individual circumstances –most people may be successfully treated.
      • Hepatitis B cannot be cured but can be successfully controlled to prevent long term problems.

    For more information

    www.bashh.org

    www.livertrust.org.uk

    http://www.nhs.uk/Conditions/Hepatitis/Pages/Introduction.aspx

    http://www.britishlivertrust.org.uk/wp-content/uploads/Hepatitis-B-Low-Res-PDF.pdf

    http://www.nhs.uk/hepatitisc/what-is-hepatitisc/Pages/the-facts.aspx