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Hepatitis B and HIV/AIDS

July 2013

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Table of Contents

What Is Hepatitis B?


Hepatitis is an inflammation, or swelling, of the liver. Alcohol, drugs (including prescription medications), poisons, and some viruses can all cause hepatitis. Hepatitis B is a liver disease caused by the hepatitis B virus (HBV).

Worldwide, approximately 350 million people are infected with HBV, and one in ten of these are also infected with HIV. In the US, about 1.25 million are infected with HBV, and about one in five of these are also infected with HIV.

Most people, about nine out of every ten, fight off the hepatitis B infection themselves and usually recover within a few months. While they will never get HBV again, their blood test will always show that they have been infected.

The remaining ten percent of people -- those who do not fight off the infection themselves -- develop chronic hepatitis B. Chronic hepatitis B is a long-term illness that happens when HBV stays in the body longer than six months. Fifteen to 25 percent of people with chronic HBV develop serious complications including liver damage (cirrhosis or scarring) or liver cancer, usually after many years. In the most serious cases, a person may need a liver transplant. People with chronic HBV infection also become carriers of the infection and can pass the virus on to others.

There is very little woman-specific information about HIV/HBV co-infection. However, it is known that, although people with both HIV and HBV have less inflammation in the liver, they have higher rates of HBV-associated liver disease. Several studies have also shown that HBV infection could increase the risk of liver damage for people taking HIV medications.

How Is HBV Spread?

HBV is more contagious than HIV. It is spread through infected bodily fluids, including blood, semen, vaginal secretions, and breast milk. HBV can be spread through:

  • Unprotected sexual contact with exchange of genital fluids
  • Sharing injection needles or 'works'
  • Sharing needles that are used to apply tattoos
  • Sharing toothbrushes or razors with an infected person
  • Receiving a transfusion of blood, blood products, or organs before 1975
  • Mother-to-child transmission (during birth)
  • Open sores

People with HBV infection may also be at risk for infection with hepatitis C virus (HCV) or HIV.

Prevention of HBV

Fortunately, if you have never had HBV, it can be prevented. Getting vaccinated for HBV is the best protection against the virus. In order to be fully protected, three shots are required over the course of six months. There is also a combined vaccine that will protect you from both HBV and hepatitis A (HAV). It is important to follow through and get all your shots in order to be fully protected.

HBV vaccination is recommended for all infants (first dose at birth), all children younger than 19 years who have not been vaccinated, and all sexually active persons who are not in a long-term monogamous relationship with someone who does not have hepatitis B. It is also recommended for people living with HIV (HIV+), men who have sex with men, people with multiple sex partners or a diagnosis of a sexually transmitted disease, injecting and non-injecting drug users, people who have close household contact with an HBV-infected person, and health care workers.

The HBV vaccine is recommended for HIV+ people. However, HIV infection can reduce the response to the HBV vaccine. HIV+ people who are vaccinated should be tested for HBV antibodies one to two months after the third vaccine dose to make sure your body is fully protected against HBV. Revaccination or higher doses of vaccine may be necessary for people who do not respond to the first three regular doses.

People who do not respond to additional doses may remain susceptible to HBV infection and should consider taking additional action to prevent infection with HBV. Examples of such preventive action include: using latex barriers during sex (see our Safer Sex info sheet), not sharing needles or drug equipment, and making sure that tattoo artists use sterile needles and sterile inkwells.

Babies born to women carrying HBV are at high risk of getting HBV immediately after delivery. The risk is increased in women who are co-infected with HIV. It is now recommended that all pregnant women be tested during the first three months of pregnancy for HBV. The HBV vaccine is safe during pregnancy and is recommended for the infant if the mother tests positive during pregnancy. Babies born to HBV-positive mothers get the first shot of HBV vaccine at birth as well as one shot of HBIG (Hepatitis B Immune Globulin), which helps them fight off HBV infection.

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This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.
See Also
Talk to a Physician About HIV/Hepatitis Coinfection in Our "Ask the Experts" Forums
More on Hepatitis B

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