Hepatitis

Hepatitis means 'inflammation of the liver' and it can be caused by viruses passed on during sex. Different viruses cause different types of hepatitis, some of which are more serious than others.

Hepatitis A, B, and C are the most common viruses. Vaccinations can protect against hepatitis A and B, but not against hepatitis C. A combined vaccine protects against both A and B.

Hepatitis A

What causes hepatitis A?

Hepatitis A is caused by a virus found in human waste. It’s spread when tiny amounts of human waste get into the mouth.

Symptoms

Symptoms can be mild, so you may not realise you have hepatitis A, but up to six weeks after being infected you may feel mild flu-like symptoms. Other symptoms are:

• Fever or diarrhoea
• Feeling sick and very tired
• Loss of weight
• Pain in the stomach
• Feel sick when faced with tobacco smoke, fatty foods and alcohol
• Itchy skin

You may also get jaundice, which means:

• Your skin and the whites of your eyes turn yellow
• Human waste goes a pale colour when passing
• Urine is dark coloured

How is hepatitis A passed on?

The virus, contained in human waste, needs to get into your mouth to infect you. Very small traces of human waste can be left on your hands and on food prepared by an infectious person. Water can also become contaminated, especially abroad.

During sex human waste can get on your fingers and in your mouth through:

• Oral sex (specifically rimming)
• Anal sex without condoms
• Handling used condoms and dildos
• Inserting fingers into the anus

Vaccinations

There are two types of vaccinations against hepatitis A. One protects for only a few months; it's called immunoglobulin and is given to people travelling to countries where hepatitis A is common. The other protects for years (this is the one gay men need). The first injection protects for a year; a second is given a few weeks later to increase your protection to 10 years. After 10 years you need a booster injection.

Where to get vaccinated

The hepatitis A vaccination is free and you can get from your GP or a GUM clinic. Your GP may give you the vaccination if you say you’re gay, but you may not want your GP to know this.

Treatment

The treatment for hepatitis A is plenty of rest, which can mean weeks off sick. Your doctor will tell you how long you should avoid drinking alcohol for, while your liver recovers, and you will need to avoid recreational drugs.

A blood test can show when you have fully recovered.

Protect yourself and others

Using a condom can help protect against getting hepatitis A. Remember that using a condom will help protect you against getting or passing on other sexually transmitted infections. Dental dams can also be used during oral sex and rimming for safer sex. You can order free safer sex packs from Trade here.

Hepatitis B

Hepatitis B is very infectious and can be easily passed on during sex. Many people get it without realising. For others it can mean months of feeling ill and not being able to drink alcohol. For a few people who get it, it will be fatal.

What causes hepatitis B?

Hepatitis B is caused by a virus that attacks the liver. It's found in body fluids like blood, semen and saliva.

Symptoms

Many people have no symptoms. But weeks or several months after getting infected you may get a flu-like illness which can be mild or more severe.

Other symptoms can include:

• Fever
• Headaches
• Having no appetite
• Being sick
• Feeling pain in the stomach
• Itchy skin

You may also get jaundice, which means:

• Your skin and the whites of your eyes turn yellow
• Human waste goes a pale colour when passing
• Urine is dark coloured

The majority of people get over the symptoms, suffer no lasting damage and stop being infectious. One in ten people who get the virus become 'carriers', which means they feel fine but can still infect other people.  Roughly one in 100 people die from Hepatitis B infection.

How is hepatitis B passed on?

The virus is usually in:

• Blood
• Semen
• Vaginal fluid

The virus is a lot more infectious than HIV, so it's much easier to get or pass on during unprotected sex. It can be passed on through:

• Anal sex
• Oral sex
• Rimming
• Sharing sex toys

It can be passed on by sharing toothbrushes or razors (they could have infected blood on them).

The virus can be in saliva and urine, so it's possible it could be passed on through kissing and water sports, but this isn't common.

Vaccination

Gay men are at greater risk of hepatitis B, GUM clinics offer free vaccinations. Some GPs also give the vaccine but this means telling them you are gay and you may not want this to go on your medical records.

You might be given a blood test before you’re vaccinated which shows if you've already had hepatitis B. If you have you’re now immune, can’t get it again and don't need the vaccine.

The vaccinations are given as two or three injections over four weeks. You only get the full protection if you have had all three of the injections. A blood test 8 weeks after the last injection will show if the vaccine has worked. After 5 years you may need another booster injection.

How is hepatitis B treated?

You will need plenty of rest if you get hepatitis B, which can mean many weeks off sick. You may have to stop drinking alcohol and avoid recreational drugs for up to a year whilst your liver recovers.

If tests show you are a carrier, medication may be able to control the virus.

Protect yourself and others

Using a condom can help protect against getting hepatitis B. Remember that using a condom will help protect you against getting or passing on other sexually transmitted infections. Dental dams can also be used during oral sex and rimming for safer sex. You can order free safer sex packs from Trade here.

Hepatitis C

Hepatitis C is the most serious type of hepatitis. It is nowhere near as common within gay men as hepatitis A and B, but gay men who have injected drugs in the past or had unprotected sex that involves coming into contact with another person’s blood are more likely to get it.

What causes hepatitis C?

Research suggests Hepatitis C is caused by a virus that is not passed on very easily through sex.

Symptoms

Very few people with hepatitis C notice any symptoms when first infected. Even over time symptoms are difficult to spot, and it can take years before you feel ill; but eventually it can cause the same symptoms as hepatitis A and B. Extreme tiredness, mental confusion and depression can also be symptoms.

Many people with untreated Hepatitis C eventually develop some kind of liver disease, such as liver cancer. You many need a liver transplant.

How is hepatitis C passed on?

The virus is mainly in blood and is spread when infected blood gets into another person’s body, it could also be passed on through semen and vaginal fluid.

It can be passed on through:

• Anal sex if condoms aren't used, especially as bleeding can happen during penetration and fisting
• Vaginal sex if condoms are not used properly as bleeding can happen during penetration and menstruation
• Injecting drugs if equipment is shared

Vaccination

There is no vaccine for hepatitis C. The following can reduce the risk:

• Using a condom for anal sex
• Using a condom for vaginal sex
• Using latex gloves for fisting
• Avoid sharing toothbrushes and razors with someone you know has the hepatitis C virus
• Not sharing equipment when injecting drugs
• Dental dams can also be used during oral sex and rimming for safer sex

How is Hepatitis C treated?

Infection is confirmed through a blood test which looks for hepatitis C antibodies; these can take up to six months to appear in the blood.

Treatment lasts 6 - 12 months and involves drugs. This is successful for the about half of people treated.

Left untreated Hepatitis C can cause liver damage.

Protect yourself and others

Using a condom can help protect against getting hepatitis C. Remember that using a condom will help protect you against getting or passing on other sexually transmitted infections. Dental dams can also be used during oral sex and rimming for safer sex. You can order free safer sex packs from Trade here.