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Hepatitis B, Reconsidered

Why another article on Hepatitis? Because Hepatitis B is a very important health consideration for gay and bisexual men, yet an alarming number of gay men do not know enough about it. It is more common than HIV and is more easily spread. It causes a serious illness and is sometimes fatal. However the most important reason to keep talking about it is that it is easily preventable with a vaccine, which many gay and bisexual men have not yet gotten.

Hepatitis B (Hep B) is a virus that is spread much the same way HIV is. It is spread through blood, bodily fluids, and sharing needles. However, it takes less virus to infect you than HIV does. Therefore you are much more likely to catch Hep B from an unprotected sexual encounter than HIV. Also, it is more easily passed through oral sex.

Symptoms of hepatitis usually begin about 1 to 6 months after initial infection with Hep B. Like HIV, this virus can be passed to others before symptoms begin. Early symptoms are usually flu-like such as fatigue, body aches, night sweats, nausea, and fever. In fact, is it usually assumed to be a cold or flu during the early stages. Joint pains or arthritis are common. As the liver damage worsens, abdominal pain, itching, dark ("Coca Cola") urine, and light (clay colored) stools are common. The most classic sign of hepatitis is jaundice. This is a yellow tint to the skin and white parts of the eyes. The jaundice may not appear until 2-3 weeks after the first symptoms begin.

Hepatitis B affects people differently. Many people have mild symptoms. In fact, at least half of people who are positive for Hep B do not know they have it. However many people do get very sick from it, and may take several months to recover from it. Most do recover in about 6 months and are no longer contagious. About 1-4 % of people who catch it, will get liver failure, dying from it or requiring liver transplant. About 10% of people who catch Hep B will develop chronic active hepatitis, which eventually leads to cirrhosis and liver failure in about 20 years. The people who develop chronic hepatitis often have mild symptoms at the time of infection. Therefore, unless they are tested for it, they usually do not know they have it. They can also continue to pass the virus to others for many years.

The interesting part of the hepatitis story is that it is completely preventable. Practicing safer sex, which we should all be doing, will certainly reduce your chances of catching it. There is also a highly effective vaccine available. It is a 3 shot series. The second dose is given 1-2 months after the first. The third dose is given 6-12 months after the first. There is also an immune globulin shot, which can be given within a week after exposure, to reduce the risk of infection. For those already infected, there are new treatments for chronic hepatitis that will slow or even stop the liver destruction.

If you haven’t thought much about Hepatitis B you should. If you know you have Hepatitis B, seek treatment. There are new options. If you have not been tested for it, get tested, both for your own health and the health of your sexual partners. This is the only way to detect an infection that could be smoldering for years. If you have not been vaccinated or did not complete the series, get vaccinated. If you have gotten vaccinated, you may need blood work to check your immunity, especially if you have HIV. If you have questions please talk to your doctor.

 

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