Hepatitis B

Hepatitis B infection can cause liver disease. Hepatitis B is transmitted through contact with bodily fluids such as blood, and during unprotected sex. It is not a very common infection in the community, however it is far more common in prisons.

Hepatitis B is a very serious disease which can result in life-threatening liver problems, such as liver cancer of liver failure. It is very important as prison staff to be aware of how to protect yourself from hepatitis B and how to prevent possible infection in prisons.

The disease

Viral liver disease, and in some cases, liver cancer. Viral means it is caused by a virus.

How does it feel?

People who are infected with hepatitis B can have high temperature, tiredness, pain in the tummy area, feeling of being sick, yellowing of the skin and eyes, and patches of raised and itchy skin. Some people who are infected have no symptoms.

What is severe disease like?

People who are infected with hepatitis B for a long time with no treatment can develop to fatal liver cancer or liver failure. Hepatitis B caused an estimated 820,000 deaths worldwide in 2019.

How does it spread?

Hepatitis B can spread through contact with bodily fluids of an infected person. This can include through unprotected vaginal, anal or oral sex, injecting drugs using shared or unclean needles, being injured by a used needle or another infected object, having a tattoo or piercing with unsterilised equipment, or specific contact with blood or saliva.

Who is at risk of getting it?

People who have liver or kidney disease, people who are HIV positive, people who work or live in an environment of heightened risk such as a prison, and people who have high-risk behaviours, such as being frequent drug users or sex workers, are more at risk of being infected with hepatitis B.

Why does it matter in prisons?

Things we see more commonly in the prison population, such as being HIV positive, shared or unclean needle use, or unprotected sex, also make you more likely to be infected with hepatitis B. Within prisons, people might share needles for drug use or tattooing, or be having unprotected sex, which further increases the spread of hepatitis B. Studies indicate that persistent hepatitis B infection is up to ten times higher in prison than in the general community. Incidents in prisons can also expose people living in prison and prison staff to hepatitis B infection, such as contact with infected people’s faeces, or fights when there might be contact with an infected person’s blood or saliva (eg. through biting).

How effective is the vaccine?

Vaccination is highly effective against hepatitis B and offers 98 – 100% protection against infection. The vaccine schedule usually requires three doses in order to be completed.

How safe is the vaccine?

Hepatitis B vaccine is a very safe vaccine. Common side effects include soreness, redness and swelling of the arm where the shot was given, headaches or fevers. Serious side effects, such as anaphylaxis, are incredibly rare, around 1 in 1 million.

Did you know?

Vaccine schedules for hepatitis B all require three doses, and can be standard or accelerated. Due to the high turnover of prison populations, the accelerated programme, in which booster doses of vaccine are given at shorter intervals, is often used in prisons. It is more effective as it means people are more likely to complete their full vaccination course before leaving the prison and be protected against hepatitis B.