Can I get hepatitis B from my partner?
Through sex, yes: the CDC counts unvaccinated adults with a sex partner who has hepatitis B as being at increased risk. That includes a husband, if he is your sex partner.
Hepatitis B is primarily spread when blood, semen, or certain other body fluids – even in microscopic amounts – from a person infected with HBV enter the body of someone who is not infected.
Sex with a person who has the virus is one route the CDC names, and so are birth and direct contact with blood or open sores. Sharing a toothbrush or a razor can spread it, though that is less common, and NIDDK also names nail clippers.
You can have hepatitis B with no symptoms, and you can still pass it on. About 1 in 2 people with hepatitis B do not know they are infected. Getting tested is the only way to find out if you are infected, and the CDC recommends screening all adults 18 and older at least once in their lifetime.
Hepatitis B is a liver disease caused by the hepatitis B virus, and the infection can be short (acute) or long-term (chronic). The CDC estimates that about 640,000 adults in the US have chronic hepatitis B, and a separate CDC estimate is approximately 660,000 people age 6 and older.
Is hepatitis B a sexually transmitted infection?
HBV is predominantly a blood and sexually transmitted infection and is spread by percutaneous and mucosal exposure to infectious body fluids.
The WHO groups hepatitis B with herpes simplex virus, HIV, and HPV as viral sexually transmitted infections. Which STDs can’t be cured covers what “no cure” means for each of the four.
The WHO says the virus is most commonly transmitted from mother to child during birth and delivery, in early childhood, and through blood or other body fluids during sex with an infected partner, unsafe injections, or exposures to sharp instruments. In the United States, hepatitis B spreads among adults mainly through contact with infected blood through the skin, most often during injection drug use or sexual contact. The WHO says sexual transmission is more prevalent in unvaccinated people with multiple sexual partners.
Can I kiss someone with hepatitis B?
Although HBV can be found in saliva, it is not spread through kissing or sharing utensils.
Saliva can transmit the virus through a bite.
The CDC also says it is not spread through sneezing, coughing, hugging, or food or water. The WHO says the virus can spread through infected blood, vaginal fluids, semen, and saliva when open cuts and sores are present.
Does the hepatitis B vaccine protect me?
The best way to prevent hepatitis B is by getting vaccinated.
You need all the shots in the series to be fully protected.
The series is two or three shots, depending on the brand. Your doctor gives the three-shot series over a 6-month period, and the two-dose vaccine about one month apart. The vaccine gives you long-term protection against illness from acute and chronic infection.
HepB vaccine is 80% to 100% effective in preventing infection or clinical hepatitis in those who receive the complete vaccine series.
The CDC says more than 90% of infants, children, and adolescents, and more than 90% of healthy adults younger than age 40, develop a protective antibody response after a complete series. By 60 years, only 75% develop protective antibody titers.
The CDC recommends the vaccine for all infants, children, adults through age 59, and adults age 60 and over with risk factors; adults 60 and older with no risk factor who want protection may be vaccinated. You don't have to name a specific risk factor to get it, and sex partners of people who have hepatitis B are at higher risk. If you are pregnant, the CDC says the hepatitis B vaccine is safe for pregnant women, and NIDDK says some hepatitis B vaccines are safe during pregnancy. If you are an unvaccinated sex partner, household contact, or needle-sharing contact of someone who is HBsAg-positive (a positive hepatitis B surface antigen test), you should be tested for susceptibility, and the first dose should be given immediately after the blood is drawn.
What if I've already been exposed?
See a doctor right away if you think you have been in contact with the hepatitis B virus. When indicated, immunoprophylaxis should be initiated as soon as possible, preferably within 24 hours.
Sex or needle-sharing contact with an HBsAg-positive person is an exposure in the CDC table. If you were never vaccinated, you should get the hepatitis B vaccine series and HBIG. If you started the series and didn't finish, you should complete it and get HBIG.
Studies are limited regarding the maximum interval after exposure during which postexposure prophylaxis is effective, but the interval is unlikely to exceed 7 days for percutaneous exposures or 14 days for sexual exposures.
If you were never vaccinated and the other person's HBsAg status is unknown, the table's instruction is to start the hepatitis B vaccine series. The table applies to exposures outside of work, and the hepatitis B vaccine series should still be completed.
People with HBsAg should be advised to use methods such as condoms to protect a sex partner who is not immune, until that partner has been vaccinated and immunity is documented. Sex and needle-sharing partners of someone who is HBsAg-positive are among those recommended for anti-HBs testing 1 to 2 months after the last dose, if that test is indicated.
Can we have a normal relationship and a family?
People with hepatitis B can live healthy and normal lives; it is important to see a doctor to optimize your care.
When the pregnant person has hepatitis B, the vaccine and HBIG will greatly reduce the chance the baby gets the infection.
Every pregnant woman should have a hepatitis B blood test as part of prenatal care, because the virus can pass easily from a pregnant woman to her child during a vaginal delivery or a C-section. If you are pregnant, that test is yours even when your husband is the one with hepatitis B. The baby will get 3 or 4 shots in total, and all of them are necessary. If that test shows hepatitis B, the baby should get the hepatitis B vaccine and HBIG right after birth.
Chronic hepatitis B can be treated with antivirals, which can help fight the virus and slow damage to the liver, but not everyone needs them and they are only helpful for some people. People who start hepatitis B treatment may need to take medication for the rest of their lives because these medications do not lead to a cure.
The WHO says there is no specific treatment for acute hepatitis B, and that most people who start treatment must continue it for life. If virus levels are high during pregnancy, a doctor may recommend treatment, which can lower virus levels and reduce the chance of spread to the baby.
Among adults with normal immune status, approximately 95% recover completely from newly acquired HBV infections, eliminating the hepatitis B surface antigen (HBsAg) from the blood and producing neutralizing antibodies that confer immunity from future infection.
The CDC says approximately 90% of infected infants and 30% of children infected between 1 and 5 years will remain chronically infected with hepatitis B. People who live with someone who has hepatitis B are at higher risk, because the virus is very infectious and can pass between family members through blood, semen, or other body fluids, and the baby's family and anyone else in the household should be tested and vaccinated if needed.
Dating someone with hepatitis B
Your sex partners should get a hepatitis B test. If they are not infected, they should get the hepatitis B vaccine.
PositiveSingles asks for an STD status at sign-up, and hepatitis there is an example, not a hepatitis B-only label. The line reads Specify your STD status, such as herpes(HSV1, HSV2), HIV, HPV, hepatitis, or others.
For where people meet, see where to meet people who get it.
