Hepatitis B

Infectious Disease

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The hepatitis B virus is a major cause of serious, life-threatening liver disease, including liver cancer and cirrhosis (scarring of the liver caused by long-term liver damage).

In 2017 the World Health Organization (WHO) estimated that around 250 million people worldwide were chronically infected with hepatitis B virus. In areas such as sub-Saharan Africa, most of Asia and the Pacific islands, 10% or more of the population have chronic hepatitis B infection.

The UK has generally low levels of hepatitis B disease, but there is variation between different parts of the country. Because of the risk to newborn babies, since 1998 there has been a screening programme for pregnant women in the UK. Overall, about 4 in 1000 pregnant women in the UK are found to be infected with hepatitis B, but in areas such as inner cities the rates may be much higher than this.

 

Many people do not show any symptoms, and may not even know they have been infected. Even so, during their infection, they can pass the disease on to others.

Hepatitis B sometimes causes flu-like symptoms, such as tiredness, general aches and pains, headaches and a high temperature. It can also lead to loss of appetite, sickness, diarrhoea, yellowing of the skin and eyes (jaundice), and pain in the upper right-hand side of the tummy (abdomen).

If they do appear, symptoms will normally begin two to three months after exposure to the virus, and last for several months. But the infection can persist for longer, and may never go away. These chronic infections can lead to serious liver problems such as liver cancer and cirrhosis (scarring of the liver). Cirrhosis prevents the liver from working properly; the damage cannot be reversed and eventually the liver may stop working altogether.

 

The hepatitis B virus is transmitted by blood and bodily fluids; in the UK this occurs mainly through sharing needles for drugs such as heroin, or through unprotected sex. Babies born to mothers who are infected with hepatitis B are at high risk of becoming infected themselves during birth. Infection in this way leads to long-term chronic infection in 90% of cases, and puts the child at risk of serious liver disease later in life.

 

Since the disease is so serious, the World Health Organization has said that all babies in the world should be protected by the hepatitis B vaccine. In 2017 the UK decided to introduce a 6-in-1 vaccine for all babies, which protects against hepatitis B as well as against five other serious diseases. This vaccine replaced the 5-in-1 vaccine for all babies born on or after 1st August 2017. See the Public Health England statement for more information.

There is also an individual (monvalent) vaccine that gives protection against the hepatitis B virus. In the UK this vaccine is given to those at the greatest risk of infection. This includes babies born to mothers who have hepatitis B infection. If these babies start a programme of vaccination immediately after birth, it can prevent 90% of them from developing chronic hepatitis B infection.

 

Page last updated Thursday, January 4, 2018