What is hepatitis?
Hepatitis is inflammation of the liver. Hepatitis may be caused by alcohol, drugs, toxins or infection with a virus (called viral hepatitis). There are 5 viruses known to cause hepatitis. The most common are hepatitis A, B and C. Hepatitis B is a sexually transmissible infection (STI) and blood-borne virus (BBV), which means it can be passed on through sexual contact or by blood to blood contact.
Hepatitis A and C are not considered STIs however, they can be transmitted (passed on) during some types of sexual contact. Hepatitis C is a BBV.
- hepatitis A is rare and sexual transmission mostly affects men who have sex with men (MSM)
- hepatitis B mostly affects people who come from countries with a high incidence of hepatitis B (e.g. South East Asia, Sub-Saharan Africa, Pacific Islands). Aboriginal and/or Torres Strait Islanders are also at increased risk.
- hepatitis C mostly affects people who inject drugs.
Viral hepatitis can be acute (a short infection that you recover from) or chronic (infection for a long time or for life).
How do you get hepatitis?
The different types of hepatitis virus are passed on in different ways.
Hepatitis A is passed on through faeces (poo), from a person with hepatitis A, entering the mouth of a person not infected with hepatitis A. It is mainly when a person consumes food or drink contaminated with small amounts of infected faeces. Hepatitis A can also be passed on during the sexual practice of rimming (mouth on anus).
Hepatitis B is passed on through blood and sexual fluids (semen (cum) or vaginal fluids), from a person with hepatitis B entering the bloodstream of a person not infected with hepatitis B. It is mainly passed on during unprotected sexual contact or behaviours involving blood to blood contact – such as sharing drug injecting equipment (needles, syringes, spoons, swabs, tourniquets, water and filters) or sharp equipment (e.g. razors or nail clippers), tattoos or body piercing. Infection through blood may also occur during needle stick injuries (usually with healthcare workers).
Hepatitis C is passed on through blood, from a person with hepatitis C, entering the bloodstream of a person not infected with hepatitis C. It is mainly passed on through sharing drug injecting equipment (needles, syringes, spoons, swabs, tourniquets, water and filters). It may also be passed on through sharing sharp equipment (e.g. razors or nail clippers), tattoos, body piercing or needle stick injuries (usually with healthcare workers). Hepatitis C can be passed on during sexual practices that involve blood to blood contact. This risk is higher for people who are living with the human immunodeficiency virus (HIV).
Transmission of hepatitis through sexual contact can affect anyone who is sexually active. It can be passed on whether your sexual partner/s are the same sex as you or a different sex. Sexual contact may be vaginal or anal sex or sharing sex toys and in the case of hepatitis A – rimming (mouth to anus). Infected sexual fluids or blood (including menstrual blood) must enter the bloodstream for hepatitis B or C infection to occur.
Hepatitis B and C can also be passed on from a pregnant person to a baby in the uterus (womb), during delivery (birth) or during breastfeeding (only if nipples are cracked or bleeding).
How do I know if I have hepatitis?
Regular STI and BBV testing is the best way to know if you have hepatitis.
Many people with hepatitis do not know because they do not have symptoms, do not notice symptoms or believe the symptoms to be a different illness.
Some people might have symptoms such as:
- muscle aches
- swollen glands
- abdominal pain
- yellowing of the skin or eyes (jaundice)
- dark yellow urine
- nausea, vomiting and diarrhoea
- pale or grey poo.
What does a test involve?
Testing for hepatitis involves a blood test (usually from your arm) taken in a clinic which is sent to be processed at a laboratory. The blood test checks for hepatitis antibodies – proteins that the immune system makes in response to hepatitis infection. Some laboratory tests will also check for hepatitis antigens – proteins that are a part of the virus. Blood tests can check if you have ever been infected with a hepatitis virus, whether you currently have the virus in your blood, the stage of infection (acute or chronic) and if you have every been vaccinated for hepatitis A and B.
It can take time for a blood test to detect infection with hepatitis. The time between infection to a positive blood test is called the window period. The length of the window period is dependent on the type of hepatitis.
If your test result is negative and you have been at risk of hepatitis or have symptoms, you may need to repeat the test in a couple of weeks. It may be too early in the infection (within the window period) for a blood test to detect antibodies to hepatitis.
If your test result is positive, you may need another blood test to confirm you have a current hepatitis infection, measure the stage of infection, check if you have cleared the virus and/or check if your liver has been damaged. You may also need a liver ultrasound or biopsy.
You may choose to test for other STIs or BBVs at the same time as testing for hepatitis. More information on STI and BBV testing
Sexual Health Victoria (SHV) provides expert, confidential STI and BBV testing to Victorians. We also provide expert information, healthcare and support on a range of reproductive and sexual health matters. For more information on SHV clinical services, see our clinics or you can book an appointment online.
How is hepatitis treated?
Hepatitis does not always require treatment. In many cases the hepatitis virus causes an acute infection that is cleared by your immune system. In other cases, antiviral medications can be taken to prevent the virus from multiplying, manage symptoms or clear the virus completely.
Hepatitis A is usually a short-term acute infection that is cleared by your immune system and does not require antiviral treatment.
Hepatitis B is usually cleared by your immune system. Chronic hepatitis B can be treated but not cured with antiviral medications.
Hepatitis C may be cleared by your immune system in the first year of infection in around 30% of people. Chronic hepatitis can be cured with antiviral medications in most people.
You can speak to your specialist, doctor or nurse for more information on treatment options.
Where do I get treatment?
Your specialist, doctor or nurse will give you the antiviral medications or a script which you can take to the pharmacy. You cannot buy medications to treat hepatitis over the counter without a script.
It is recommended you see a health care professional experienced in hepatitis care for regular treatment, monitoring and review. This may be at a general practice, liver clinic in a hospital or specialist clinic.
What if I do not get treated?
Hepatitis can cause serious health complications if not treated.
If a person has hepatitis B or C for more than 6 months it is considered a chronic infection. Without treatment, chronic hepatitis can affect your health and cause cirrhosis (scarring of the liver), liver failure or liver cancer.
If you do not get treated for hepatitis, you can pass the infection to your sexual partners or injecting equipment sharing partners — even if you do not have symptoms.
Will hepatitis come back?
When the immune system clears infection with hepatitis A and B, you usually develop immunity and cannot be re-infected.
When the immune system or antiviral treatment clears infection with hepatitis C antibodies do not provide any immunity to hepatitis C and re-infection can occur.
Antiviral medications can cure hepatitis C and can control chronic hepatitis B. Other lifestyle factors that can reduce your risk of liver damage include:
- Reduce or stop drinking alcohol
- A balanced healthy diet
- Regular exercise
- Maintaining a healthy body weight
- Regular contact with your GP or specialist.
Do I need to let my sexual partner/s know I have hepatitis?
If you have been diagnosed with hepatitis A or C you are not obligated to let your sexual partners know, provided they are not at risk of being infected with hepatitis. This means using prevention methods such as barrier protection (external condoms or internal condoms) and not sharing equipment where there is a risk of blood exposure. You may choose to inform your sexual partner/s you have been diagnosed with hepatitis A or C.
If you have been diagnosed with hepatitis B it is recommended you let your sexual partner/s know so they can make informed decisions about ways to lower the risk of passing it on and be tested and treated. It is recommended you contact any sexual partner you have had in the last 6 months.
There are some great websites to support you informing your sexual partners via a phone call, text message, letter or email. There are ways of doing this either personally or anonymously.
- Let Them Know
- The Drama Downunder – for men who have sex with men
- Better to know – for Aboriginal and Torres Strait Islander people
Your doctor or nurse can assist with informing your current or previous sexual partners.
What should I do if my sexual partner has ben diagnosed with an STI or a BBV?
You may be notified that a sexual partner of yours has been diagnosed with an STI or a BBV. Notification may be in person or via a phone call, text message, letter or email. You may have an infection too and be unaware as you may not have symptoms. See your doctor or nurse to discuss ways to lower the chances of passing it on, get tested and treated.
Will hepatitis affect my pregnancy or breastfeeding?
People who are pregnant or breastfeeding can be infected with the same STIs and BBVs as people who are not pregnant or breastfeeding.
If you are infected with an STI or BBV during pregnancy it can cause serious health complications for both you and your baby. Complications can include:
- Infection in the uterus (womb).
- Passing the infection to the baby (during pregnancy, birth or breastfeeding) causing health conditions.
- Premature (early) birth.
Hepatitis B and C can be passed on through blood from a pregnant person to a baby in the uterus (womb), during delivery (birth) or during breastfeeding (only if nipples are cracked or bleeding). Hepatitis is not passed on though breast milk.
If you have hepatitis during pregnancy, there are medications that can be used during pregnancy and after delivery to help reduce the chance of hepatitis infection in your baby.
If you are pregnant or breastfeeding and considering treatment for an STI or BBV, ask your doctor, nurse or midwife about the possible effects of the treatment or medicine on your baby or breastfeeding.
If you are planning a pregnancy or already pregnant, it is recommended you and your sexual partner/s (and injecting equipment sharing partners) have STI and BBV screening tests, even if you have been tested in the past. Hepatitis B and C testing are part of a routine antenatal screen. You can speak to your doctor, nurse or midwife for more information.
How can I lower my risk of getting STIs and BBVs?
You can lower your risk of getting STIs and BBVs by using barrier protection (external condoms, internal condoms or dental dams) correctly during any type of sex (vaginal, anal or oral sex) and when sharing sex toys.
Barrier protection is not 100% effective at preventing STIs and BBVs.
You can also lower your risk of getting a BBV by:
- not sharing injecting equipment, razors, nail clippers
- only getting tattoos and piercing in regulated places
- talking to your doctor or nurse about HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) if you are at risk of HIV exposure.
You can also lower your risk of getting an STI or BBV by both you and your sexual partners having regular STI and BBV testing. To get an STI or BBV test at Sexual Health Victoria, see our clinics or you can book an appointment online.
There are vaccines to prevent infection with hepatitis A and B. Some vaccines are free, under the National Immunisation Program (NIP).
You can discuss your vaccine options with your doctor or nurse.
Where to get more information and support
- Sexual Health Victoria
- Better Health Channel
- The Centre Clinic – a safe and friendly general practice, providing care for LGBTI community members as well as specialist medical care for people living with hepatitis, and expert sexual health screening and treatment.
- DirectLine 1800 888 236 – support for people affected by alcohol and other drugs including information on where to obtain new needles and syringes.
- Equinox – for transgender services
- Headspace – for young people
- Hepatitis Victoria – community organisation for people affected by, or at risk of, liver disease and viral hepatitis.
- Hepatitis Australia – peak community organisation to progress national action on issues of importance to people affected by hepatitis B and hepatitis C.
- Melbourne Sexual Health Centre – a specialist sexual health clinic.
- Minus 18 – for young lesbian, gay, bisexual, transgender and intersex (LGBTI) people.
- Multicultural Centre for Women’s Health – for culturally and linguistically diverse women.
- PRONTO! – a peer-led service for men who have sex with men.
- Thorne Harbour Health (formerly Victorian AIDS Council)
- TouchBase – information, support and services for LGBTI people.
- A doctor or nurse.
- Your local community health service.
If you are using the internet for information, only use reliable and reputable websites. Be aware of websites containing inaccurate and harmful information and imagery.