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Everything you need to know about hepatitis

We spoke to the team at The STI Clinic to get the facts on how hepatitis is contracted, treated and cured.

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Hepatitis A is very rare in the UK – but hepatitis B and C are much more common. All strains of hepatitis are diseases that affect the liver – but they are very different viruses which means they all need to be treated differently.

Both Hep B and C can remain outside the body for over 4 days, which makes them more contagious than a disease like HIV.

Get informed on the facts:

Hepatitis A

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Hepatitis A is a liver infection that’s spread by a virus in faeces (poo). It’s rare in the UK but if you are likely to travel to countries where the disease is common you can get the hepatitis A vaccine to protect yourself against it.

Hepatitis A is spread mainly through contaminated food or poor handwashing, but also passes on easily through sex, including oral-anal sex (“rimming“) and giving oral sex after anal sex. Gay and bisexual men with multiple partners are particularly at risk.

Symptoms of hepatitis A can appear up to eight weeks after sex and include tiredness and nausea.

Hepatitis A is not usually life-threatening, and most people make a full recovery within a couple of months.

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You can avoid getting hepatitis A by:

  • washing hands after sex (ideally buttocks, groin and penis too)
  • changing condoms between anal and oral sex
  • using a barrier (such as a condom cut into a square) for rimming
  • using latex or non-latex gloves for fingering or fisting
  • not sharing sex toys
  • asking about the hepatitis A vaccine at a sexual health or GUM (genitourinary medicine) clinic

If you think you might have hepatitis A, or have any questions, visit a sexual health clinic or GP.

Hepatitis B

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Hepatitis B inflames the liver and makes it unable to function properly. It’s a virus that is passed through blood, semen and vaginal fluids, so can be passed on through sexual contact (including oral sex) or through coming into contact with infected blood. Gay and bisexual men are at risk of hepatitis B, but they can be protected by the hepatitis B vaccination, which is available from sexual health clinics, genitourinary medicine (GUM) clinics or from GPs.

Hepatitis B is easier to pass on than something like HIV because it can live outside the human body for about a week.

Symptoms

In the early stages of the virus, many people only experience mild flu-like symptoms or none at all. However, people who do experience symptoms in the acute phase might experience some of the following:

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Nausea
Vomiting
Fever
Jaundice
Dark urine
Light Coloured stools

Testing and treatments

Hepatitis B can be detected from around 2 months after infection and can be picked up on a finger prick test.

If you test positive, antivirals are usually used to impact virus progression. A face-to-face follow up with a health professional is recommended to decide if further treatment is required.

Health consequences

Most people will make a full recovery after a Hepatitis B infection. Around 90% of people will completely clear the virus, having no lasting problems – a process that usually takes 3-6 months. Once the person has cleared the infection, they will be immune to future Hepatitis B infections.

Around 10% of people will have the virus long-term, known as having chronic hepatitis B. Some patients in this category will remain well but will still be infectious (carriers).

Unfortunately, it’s impossible to predict how Hepatitis B will progress in a person, so anyone who tests positive for the virus should have their recovery monitored with regular check-ups.

Hepatitis C

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Hepatitis C is a blood-borne virus that also affects the liver. It causes inflammation that prevents the liver from functioning properly, but it is a different virus to Hepatitis B. There are six different types of Hepatitis C that all require a different treatment approach.

Hepatitis C is most commonly contracted through injecting drug users sharing needles. There is also a small risk of infection through sexual activity.

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Around 7% of HIV infected men who have sex with men have had a Hepatitis C co-infection diagnosed. There is a small risk of contracting Hepatitis C through sharing notes if you are an inhaling user of drugs such as cocaine, and there is a small risk of sharing utensils that may contain traces of blood such as razors or toothbrushes, as the virus can survive for around four days outside the body.

Symptoms

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Most people will have no symptoms, or symptoms so mild that they are not detected. However this doesn’t mean that they are not infectious – they can still pass on the virus.

Symptoms that could be present in the chronic phase include:

Nausea
Lack of appetite
Fatigue
Muscle and joint aches
Concentration and memory impairment

Around 20% of people with Hepatitis C will clear the infection within six months, but 80% will go on to develop chronic Hepatitis C. About 30% of people with chronic Hepatitis C can develop cirrhosis of the liver over a long period of time, and a small number of infected people will develop liver cancer.

The Test

Hepatitis C can also be detected from a finger prick test, where Hepatitis C antibodies are detected. Further tests are then required to determine if the virus is still active, and which particular genome type it is.

Hep C can be detected from as early as 9 days post-exposure and can take up to 180 days for the antibodies to appear, so you might need to be retested a few times. In most cases, they can be detected between 45 and 65 days.

Treatment

There have been significant developments with Hepatitis C treatments, but the type of treatment depends on the strain of Hepatitis C you have. If you are tested positive you will be referred to a specialist to discuss possible treatments.

Advice given by Dr Elizabeth Kershaw-Yates, GP and one of the medical team at The STI Clinic: https://www.thesticlinic.com/


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