Hepatitis B

Hepatitis B is a liver inflammation caused by the virus HBV. It is easy to transmit, especially during sex or by sharing needles. The infection can become chronic, that is, become a long-term illness.

People with HIV should be vaccinated against hepatitis B. Statistically, they become infected with hepatitis B more often and the illness becomes chronic more often. They also suffer from cirrhosis of the liver more often.


The course of the illness varies widely. In around a third of cases, there are no signs of sickness, another third have only mild symptoms, which are often mistaken for the flu. The final third develop more severe symptoms, usually two to three months after becoming infected.

Symptoms may include fatigue, loss of appetite, muscle and joint pain, upper abdominal pain, nausea, vomiting and fever. A few days later, jaundice appears: the eyes and skin become yellow, urine becomes darker and stools become lighter.

In adults, the body is usually able to defeat the infection and symptoms disappear after several weeks. Sometimes, however, the illness becomes chronic and it must then be treated. Occasionally the illness is very severe and can even lead to liver failure.


Hepatitis B is very infectious. The virus is mainly carried in the blood, but is also present in small amounts in other bodily fluids such as saliva, semen, vaginal fluid, urine, tears and breast milk. It can enter the body through minute injuries in the skin and mucous membranes. It is usually transmitted during sex.

Sharing needles and equipment when using drugs carries a very high risk of infection. A tube used to snort drugs such as cocaine can also transmit hepatitis B in tiny traces of blood. Sharing toothbrushes, razors and nail clippers also carries a risk.


The best protection from hepatitis B is immunization. The vaccine is usually given together with a vaccine against hepatitis A. The vaccine is recommended for:

  • Men who have sex with other men
  • People at high risk from infection through sex (multiple, changing partners)
  • People with chronic liver diseases
  • People with contact to hepatitis B patients (e.g. hospital staff)
  • Drug users who inject or snort drugs

Vaccination is also possible and recommended for people who are HIV-positive.

The risk of hepatitis B can be reduced, but not ruled out, by using condoms.

The best way to protect yourself when using drugs is to always use your own syringe and equipment and to avoid using a shared tube or rolled-up note to snort drugs.


Hepatitis B is identified using a blood test.


In the first phase, only the acute symptoms are treated. Medications to treat the infection itself are only used if the illness is long or severe. The therapy lasts months to years, and must sometimes be continued for the rest of your life.

The HIV and hepatitis therapies must then be adjusted against each other, as sometimes the same medications are used.

In people with a weakened immune system, hepatitis B can sometimes suddenly return, even after it appeared to have already healed. This occurs because the virus remains in the liver and can start to replicate again from there.

Liver-damaging substances such as alcohol, drugs and unnecessary medications should be avoided during hepatitis B illness.