What are the symptoms of (acute) hepatitis B?

If you have just contracted a hepatitis B infection, it is called acute hepatitis B. 90% of children and 70% of adults with an acute infection do not notice that they have it. People who do become ill may have such symptoms as:

• tiredness
• lack of appetite, nausea and stomach complaints
• muscle pain and joint pain
• fever
• jaundice (yellowed skin, eyes, stool and urine)
• itching (sometimes)

Symptoms usually last for a few weeks. They could also persist for longer, up to 3 months. Acute hepatitis B almost never causes life-threatening symptoms.

What is chronic hepatitis B?

Sometimes acute hepatitis B turns into a chronic infection that does not go away. In case of a chronic infection, after 10 to 20 years, it could eventually cause scarring of the liver. This is called liver fibrosis. If the damage grows worse, it is known as cirrhosis of the liver. The risk of this depends on how active the virus was and on the patient’s immune response. People who have cirrhosis of the liver are also at higher risk for developing liver cancer, which can eventually lead to death. 

It is important to prevent liver damage. For that reason, it is advisable to do regular blood tests to check the liver values, so you can be treated in time to prevent serious illness.

Who can become very ill from hepatitis B?

Hepatitis B is relatively rare in the Netherlands. It is slightly more common in some groups:

• men who have sex with men
• sex workers
• people who have frequent contact with blood, wound exudate or saliva in the course of their work

Some people have a higher risk of becoming seriously ill from hepatitis B, including people with HIV and people who have other diseases that affect the liver.

Is hepatitis B dangerous during and after pregnancy?

There is a significant chance that an unborn child could contract chronic hepatitis B. That is why all pregnant people are tested for hepatitis B during their first check-up. If the pregnant person does have hepatitis B, the baby receives antibodies and the first vaccination immediately after birth. This offers the baby effective protection.

The baby could be exposed during pregnancy or birth. The risk of this depends on how active the virus is during pregnancy. Most babies who are exposed do not have any symptoms, but 90% do develop chronic hepatitis B.

Are you pregnant, and do you have hepatitis B? Tell your doctor or GP. They can refer you to a hepatitis treatment centre, where you can be assessed to see if you need treatment. Treatment could lower the risk that your unborn baby will also get hepatitis B.

A baby who has had antibodies and a vaccination right away after the birth can be breastfed by a parent who has hepatitis B. 

How does hepatitis B spread?

Hepatitis B is contagious. The virus can be found in blood, sperm, pre-ejaculate and vaginal fluids. A person could be exposed through unsafe sexual contact (without a condom or dental dam) or through blood. Blood can sometimes be on very ordinary household items without any obvious traces – such as a razor or toothbrush. Some families share these items. This is another way that others could contract the virus. The virus could also be passed from mother to child during childbirth.

People could carry the virus and infect others before they start showing symptoms. Many people do not have any symptoms at all. A person who has hepatitis B remains contagious until the virus is completely cleared from their blood. The time between exposure and illness (the incubation period) is 4 weeks to 6 months. It is usually between 2 and 3 months.

How can I prevent hepatitis B?

You can protect your child against hepatitis B with a vaccination. Since 2011, babies can get the DTaP-IPV-Hib-HBV vaccination through the National Immunisation Programme. This vaccine also protects against diphtheria, tetanus, pertussis (whooping cough), polio and Haemophilus influenzae type B (Hib disease).

People in specific risk groups can also get a free vaccination against hepatitis B through the Municipal Public Health Service (GGD). People who are at higher risk of exposure to hepatitis B at work can get vaccinated through their employer.

If you are not in a risk group, and were not vaccinated in the context of the National Immunisation Programme, you can still be vaccinated, but you will have to pay for it yourself.

Besides vaccination, there are several other ways that you can protect yourself against hepatitis B:

• Do not share your toothbrush, razor, nail clippers, nail file or tweezers with anyone else.
• Have safe sex, using a condom or dental dam.
• Be careful about contact with blood when you are bandaging a wound, and use waterproof plasters.
• Make sure that no one else’s blood can get into your cuts or wounds.
• Make sure that no one else’s blood can get into your eyes, mouth or nose.
• Do not re-use injection needles that have been used by others.
• If you get a tattoo or piercing, make sure that clean needles are used.

Do you have a cut or wound, and have you been exposed to blood from someone who has hepatitis B? Let the cut bleed freely and then rinse it off under the tap with lukewarm water. Then disinfect it with 70% alcohol or iodine, and contact your GP or the Municipal Public Health Service (GGD) near you. Have you had unsafe sex with a person who has hepatitis B? Go to your GP or make an appointment with the GGD.

Is there any treatment for hepatitis B?

90% to 95% of all adults with acute hepatitis B recover fully on their own. Treatment with medicine is not usually necessary. After recovery, these people cannot be reinfected with the hepatitis B virus. Similarly, they cannot infect others.

In 5% to 10% of infected adults, hepatitis B does not go away on its own. That means that they develop a chronic infection. The risk of a chronic infection is higher in newborns and small children. A hepatitis B infection becomes chronic in 90% of newborns who are infected. This applies to 25% to 30% of children under 5 years old.

Treatment is not needed for inactive chronic hepatitis B. There is no cure for chronic hepatitis B. Depending on how active the infection is, treatment may be needed. This involves medicine that minimises damage to the liver.

How common is hepatitis B in the Netherlands?

There are about 40,000 people in the Netherlands who are carriers of the hepatitis B virus.