Hepatitis B

How Hepatitis B Spreads

You can get hepatitis B through contact with blood and other body fluids such as semen, vaginal secretions, and/or saliva from an infected person. Hepatitis B is not spread by sharing water, food, eating utensils, or toilet seats, or by contact such as coughing, handshakes, or hugging.

The hepatitis B virus can be spread if you currently or in the past have: 

• Lived, travelled to, or had invasive health care (medical/dental) or cosmetic procedures in parts of the world where hepatitis B is more common.
• Used shared personal hygiene equipment with a known/unknown infected person, such as needles (e.g., glucose testing), scissors, nail clippers, nail files, razors, and/or toothbrushes.
• Used shared health care equipment intended for single patient use, such as needles and lancets for diabetic monitoring of blood sugars.
• Had medical, dental and/or other health care procedures, including those with equipment or instruments that have not been reprocessed properly (disinfected and/or sterilized).
• Been exposed to blood and/or body fluids through sharps or needlestick injuries.
• Had procedures with spa and aesthetic instruments, tattoo, and/or piercing equipment that have not been cleaned and reprocessed (disinfected and/or sterilized) properly.
• Engaged in unprotected sexual contact involving blood during vaginal, anal, and/or oral sex (e.g., during menstruation, or if there is a tearing of the skin or tissue).
• Shared substance use equipment, such as needles, straws, pipes, spoons, cookers.
• Were born to an infected parent (through childbirth or at home).  
• Received blood transfusion(s) or blood products that were not screened for the virus.

Symptoms & Illness

Some people may have no symptoms at all, while others may have: 

• Flu-like symptoms (fever, muscle aches, feeling tired) 
• Stomach or abdominal pain
• Loss of appetite 
• Jaundice (yellowing of the skin or the whites of the eyes) 
• Dark urine 

Symptoms appear within a few months, usually 60 to 90 days after contact with the hepatitis B virus but can range from 45 to 160 days. 

Prevention

There are many things you can do to prevent getting or spreading hepatitis B: 

• See your health care provider as soon as possible if you think you have been exposed to hepatitis B.
• Get the hepatitis B vaccine.
• Use safer sex practices including always using condoms/barriers.
• Tell your sexual partners if you have hepatitis B.
• Do not share drug equipment (needles, syringes, etc.).
• If visiting a personal service setting, such as a tattoo or piercing (ear/body) shop, check that they use sterile equipment.
• Do not share personal care items, such as razors, toothbrushes, glucometers, or manicure tools.
• Use protective equipment such as gloves to prevent contact with other people’s blood and body fluids. 
• Talk to your health care provider before donating blood, organs, tissues or sperm if you have hepatitis B or are waiting on test results for hepatitis B. 
• Follow up with routine prenatal care for each pregnancy so that newborns can get appropriate care if needed. 

Hepatitis B Vaccine

Getting the hepatitis B vaccine is the best protection against hepatitis B virus. The vaccine is safe, well tolerated, and over 95 per cent effective at preventing hepatitis B infection, and in turn prevent liver cancer. The hepatitis B vaccine is given in a two or three dose series, six months apart. 

Hepatitis B vaccination is recommended for everyone, including people with careers in health care, emergency services, and childcare. It is also recommended for travelers. Talk to your health care provider for more information.  

Students in grades 7 and 8 are offered the hepatitis B vaccine for free through Toronto Public Health (TPH) school vaccine clinics. Students in grades 7 through 12 can also get vaccinated by appointment at a TPH community clinic.

Testing & Treatment

Hepatitis B infection can be diagnosed through a blood test ordered by your healthcare provider.

A health care provider can assess the need for treatment and/or referral to a specialist if required. Chronic hepatitis B can be treated with antiviral medication. Lifestyle modifications may be needed, including monitoring for disease progression.