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B
Christine M. Kukka
HBV Project Manager;
Testing positive for the hepatitis B virus (HBV) may be scary, but there is information available that can improve your health and well-being. This fact sheet explores what testing positive means, and what you should do about it. First, don't panic - there are resources available to help you protect your health and your liver. Information is the key to living well with hepatitis B.
How to comprehend those complex viral tests
To find out more about your hepatitis B infection, a sample of your blood will be taken and examined for antigens - the proteins that make up the hepatitis B virus, as well as for antibodies, which your immune system creates to fight each of the antigens.
If you have the surface antigen (HBsAg), it means you are infected with HBV, and capable of infecting others. When you have the surface antigen for six months or longer, it means you are chronically infected. Most people experience only a short-term or acute HBV infection, but babies and adults with weak immune systems often develop long-term, chronic infections because their immune systems cannot quickly or effectively vanquish the viruses that are replicating in the liver on a grand scale. When you develop the surface antibody, it means you have cleared the virus completely and cannot infect anyone.
You will also be tested for the "e" antigen (HBeAg). When this antigen is present, it means you probably have lots of virus replicating in your liver. If you have the "e" antibody, the quantity of virus or "viral load" in your body may be low, which is good news for your liver.
Your doctor will also test your blood for HBV DNA, which is another way to measure the "viral load" in your blood.
If you have hepatitis B, you have time
Once you are confirmed as having hepatitis B, there will probably be many things running through your mind. Hepatitis B is usually a slow disease, so you will have time to make decisions about your health. Take time to learn about this infection, how it is spread, and what health problems it can cause.
You don't have to tell anyone right away, or make any snap decisions. In fact, you shouldn't make any important decisions now - you may still be in shock. There may be some days when you feel balanced and ready to take steps towards a healthier life, and other days when you don't want to deal with your infection - this is normal. Take time to think about what is important to you now, and know you will have time to make all the decisions you need to make.
Your body, your liver, and hepatitis B
The liver is your largest internal organ and has over 500 important functions. Almost everything that we eat, drink, smoke, swallow, or absorb through the skin goes through the liver. Because hepatitis B can cause liver damage, you may want to think carefully about what you put into your body so you can minimize any harm to your liver. The most harmful thing to your liver is alcohol, so it's important to reduce your alcohol intake as much as you can. Eating a healthy, low-fat, low-salt diet and drinking lots of water will help your liver do its job.
Next step: medical care for hepatitis B
It is important to find a medical specialist - a gastroenterologist or hepatologist - who has experience treating people with hepatitis B. In addition to ordering viral tests to evaluate your infection, your doctors will monitor liver enzymes, called alanine aminotransferase or ALTs. When liver cells die from the HBV infection, they release ALT into your blood. When ALT levels rise above normal, it indicates liver damage that may require treatment. Your doctor may also recommend a liver biopsy (removal of a small sliver of liver tissue) to better evaluate your liver's health, and an ultrasound of your liver. You should also get vaccinated against hepatitis A to avoid a second hepatitis infection. These tests will give you and your doctor important information so you can decide if treatment is needed. Remember to keep copies of all of your test results so you can play an active role in managing your health care.
Deciding about treatment
Most people with hepatitis B don't require treatment unless they are experiencing liver damage. There are two types of treatments available to help you get rid of HBV, and they aren't for everyone. One drug, an antiviral, stops the virus from replicating. Another drug, interferon, boosts your immune system to fight the infection. Your "e" antigen status, viral load, ALT levels, and how long you have been infected, will all be considered.
Treating hepatitis B is very expensive, and interferon treatment requires frequent injections and can cause side effects such as anxiety and depression. Talk to your doctor and others who have been treated for hepatitis B when making your decision.
How can I make sure I don't spread hepatitis B to others?
HBV spreads easily through contact with infected blood and body fluids, such as semen or vaginal secretions. That is how one in 20 Americans became infected with HBV. In addition to sexual transmission, nearly all infected mothers transmit the virus to their newborns. But there is good news, the hepatitis B vaccine safely and effectively guards babies, children, and adults against hepatitis B.
If you have hepatitis B, your household members and sexual partners should be vaccinated and you must practice safer sex with latex condoms. Always keep a barrier between you and the blood and body fluids of others. Make sure your cuts or bruises are covered with bandages, and never share items that could have blood on them, such as toothbrushes, pierced earrings, hypodermic needles or works, and nail clippers.
You cannot transmit HBV through hugging or kissing, sharing eating or drinking utensils, or sharing a bathroom.
Disclosure: Should you tell others you have hepatitis B?
You may be wondering how to tell others that you have tested positive for HBV. First, you don't have to tell anyone until you are ready. The government requires all teachers, coaches, daycare providers and others to practice standard (universal) precautions with everyone - not just people with bloodborne infections. There are two main reasons to tell others: to get support for yourself, and because you think they should get tested for hepatitis B. Think about who you want to tell, why you want to tell them, how you will tell them, and when and where you will tell them.
Getting support
If you have chronic hepatitis B you are not alone - there are more than 1.2 million others in the United States with this infection. Many people find it helpful to join a support group or connect with people on the Internet. There is an adult Hepatitis B Support List on the Internet at www.hblist.org. Many adults and families from the United States, Canada and around the world participate in this well-supervised list.
For more information about hepatitis B, contact the following organizations:
Hepatitis B Foundation
1-215-489-4900, www.hepb.org
Hepatitis B Support List
www.hblist.org
Hepatitis Foundation International
1-800-891-0707, www.hepfi.org
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