What is hepatitis B or HepB?
Hepatitis B is a vaccine-preventable infection that damages liver cells. This damage may have no symptoms, or could lead to pain, jaundice (yellowing of the skin or eyes), fever, nausea, vomiting, fatigue, or confusion. Chronic (long-term) hepatitis B can cause liver damage, liver failure, liver cancer, and even death.
Hepatitis B is caused by an infection with the hepatitis B virus (HBV). Viruses like hepatitis B invade normal cells in your body. The hepatitis B virus spreads through contact with an infected person’s blood, semen or vaginal fluid, or other body fluids. The virus can be transmitted from a birthing parent to baby during birth, between sexual partners, between people who share needles or other devices that come in contact with blood or body fluid, or through direct exposure to the blood or body fluid of an infected person. Find more information about hepatitis B and your liver. (PDF)
What is perinatal hepatitis B?
Hepatitis B virus (HBV) infection in a person who is pregnant poses a serious risk to the infant at birth. Approximately nine out of 10 infants who are infected with HBV will develop chronic hepatitis B, and approximately one-fourth of these affected infants will eventually die from chronic liver disease.
Perinatal HBV transmission can be prevented by ensuring all birthing parents know their HBV status and providing prompt care to the birthing parents and infants born to parents living with HBV. All people who are pregnant should be tested by their health care provider for HBV using a simple blood test during routine pregnancy visits. People who are pregnant and who have not been tested or who are at high risk of exposure to HBV should also be tested at the hospital before they give birth. This provides both the birthing parent and their medical team with the information needed to protect the baby.
People who are pregnant and HBV-positive may be recommended to receive medication prior to giving birth to reduce the risk of transmitting the virus to their baby. Additionally, all infants born to persons living with HBV should receive both a treatment called hepatitis B immune globulin (HBIG) and hepatitis B vaccine within 12 hours of birth. Infants should complete a hepatitis B vaccines series in the months following their birth. Visit CDC’s perinatal webpage to learn more.
Talk to your health care provider about testing for hepatitis B.
If you do not have a health care provider near you who offers care during pregnancy, you can locate a provider by visiting one of the following resources:
- Find an Obstetrics and Gynecology provider.
- Find a Community Health Center.
- Find confidential testing near you.
If you are pregnant and living with hepatitis B virus, Colorado’s Perinatal Hepatitis B Coordinator can help you find services to protect your health and the health of your baby and can be reached by phone at 303-870-6263.
Frequently asked questions (FAQs)
Hepatitis B is spread when blood, semen, or other body fluid containing hepatitis B virus enters the body of someone who does not have the virus and who has not been protected through vaccination. People can become exposed to the virus from:
- Birth (transferred from a birthing parent who has hepatitis B to their baby during birth).
- Sexual contact with a partner who has hepatitis B.
- Sharing any drug preparation or used equipment (i.e., works).
- Sharing items such as toothbrushes, razors, or medical equipment (like a glucose monitor) with a person who has hepatitis B.
- Direct contact with the blood or open sores of a person who has hepatitis B.
- Exposure to the blood from a person who has hepatitis B through needlesticks or other sharp instruments.
You can take steps to protect yourself from hepatitis B, including getting the hepatitis B vaccine if you don’t have a current HBV infection.
The hepatitis B vaccine is available for all age groups:
- For all infants, all children, or adolescents younger than 19 years who have not been vaccinated.
- All adults aged 19 through 59 years.
- Adults aged 60 years or older with risk factors for hepatitis B infection.
- Adults who are 60 years or older without known risk factors for hepatitis B may also receive the hepatitis B vaccine.
The hepatitis B vaccine may be given as a standalone vaccine, or as part of a combination vaccine (a type of vaccine that combines more than one vaccine together into one shot). The number of doses depends on your age and the type of vaccine used. The hepatitis B vaccine may be given at the same time as other vaccines.
It is safe for people who are pregnant or breastfeeding/chestfeeding to be vaccinated if they are at risk for getting hepatitis B. Pregnancy or breastfeeding/chestfeeding are not reasons to avoid hepatitis B vaccination.
People with minor illnesses, such as a cold, may be vaccinated. People who are moderately or severely ill should usually wait until they recover before getting the hepatitis B vaccine.
The vaccine is important in preventing long-term illness.
If you have a current HBV infection, the vaccine series will not benefit you or help you clear the virus, but it can provide a lifetime of protection for your loved ones. The vaccine is recommended for all children and adults up through 59 years old, as well as older adults with risk factors. Older adults without risk factors may also receive the vaccine. If you have hepatitis B, you can take steps to prevent spreading hepatitis B to others.
- Visit CDC’s webpage for the vaccine schedule for birth through 6 years.
- Visit CDC’s webpage for the vaccine schedule for 7 to 18 years.
In addition to being fully vaccinated for hepatitis B, there are other simple ways to help stop the spread of hepatitis B:
- Wash your hands thoroughly with soap and water for at least 20 seconds after any potential exposure to blood.
- Do not pre-chew food for infants.
- Use barrier protection (such as condoms, dental dams, or internal condoms) with sexual partners.
- Avoid direct contact with blood and bodily fluids. Use gloves when appropriate.
- Clean up blood and body fluid spills with a fresh diluted bleach solution (mix one part bleach with nine parts water).
- Cover all cuts carefully.
- Avoid sharing sharp items such as razors, nail clippers, toothbrushes, and earrings or body rings.
All sexual partners, family, and close household members of a person living with hepatitis B should be tested and vaccinated.
- Hepatitis B vaccination is recommended for all infants, children, and adults aged 18-59 years as well as for many people aged 60 and older. Learn more about HBV vaccination recommendations on CDC’s website.
- Find a vaccine provider near you who may also be able to help you access medical providers who can arrange for testing.
- Reference the top of the page, “Talk to your health care provider about testing for hepatitis B,” for more resources.
Hepatitis B virus can cause an acute (short-term) or chronic (long-lasting) infection. People who contract the hepatitis B virus can have later complications associated with the virus such as cirrhosis (scarring of the liver), liver cancer, and premature death. Young children, especially infants, are especially likely to develop chronic hepatitis B virus if they are infected.
Yes, all people who are pregnant should be tested for hepatitis B during a routine prenatal visit. People who are pregnant who have not been tested earlier in their pregnancy or who have risk factors for HBV exposure should be tested when they come to the hospital to give birth. People who are pregnant and who are living with hepatitis B can transmit the virus to their newborns during pregnancy or childbirth.
All people who are diagnosed with hepatitis B in pregnancy should be referred for follow-up care with a liver specialist or a doctor who is knowledgeable about hepatitis B. Your doctor may order blood tests, including the hepatitis B e-antigen (HBeAg), HBV DNA level, and other liver-related blood tests, especially liver enzymes (ALT/SGPT and AST/SGOT), to determine how active the virus is and the overall health of your liver. People who are HBeAg-positive or who have a lot of virus in their body (high viral load) have an increased risk of transmitting the hepatitis B virus to their newborn, even if their baby receives the vaccine and hepatitis B immune globulin (HBIG) as recommended. A doctor may recommend starting oral antiviral treatment during the second or third trimester to lower the viral load before delivery and continue the treatment for several months after the pregnancy.
If you are prescribed antivirals during pregnancy, you should continue to see your doctor regularly after the birth of your baby so they can make sure that you stay healthy, as well as to determine whether you would benefit from continued treatment or not.
The most important first step for all people who are pregnant to take is to get tested for hepatitis B infection.
If you are pregnant and have hepatitis B, talk with your doctor about lowering the risk the infection will spread to your baby. Your doctor may perform additional tests or recommend treatment during pregnancy. Your doctor may also refer you to a liver specialist to find out if you need hepatitis B treatment and to check for liver damage.
When it is time to give birth, tell the doctor and staff who deliver your baby that you have hepatitis B. A health care professional will give your baby the hepatitis B vaccine and a medication called hepatitis B immune globulin (HBIG) right after birth. The vaccine and HBIG will greatly reduce the chance of your baby getting the infection.
Yes, parents can breastfeed/chestfeed. All infants born to people living with hepatitis B virus should receive hepatitis B immune globulin (HBIG) and the first dose of hepatitis B vaccine within 12 hours of birth. However, there is no need to delay breastfeeding/chestfeeding until the infant is fully immunized. The risk of hepatitis B virus transmission through breastfeeding/chestfeeding is minimal if infants born to parents living with hepatitis B receive the HBIG/HepB vaccine at birth.
Data are insufficient to know for certain. However, hepatitis B virus is spread by infected blood and not through milk. Therefore, if the hepatitis B virus positive person's nipples and/or surrounding areola are cracked and bleeding, they should stop nursing temporarily. To maintain their milk supply while not breastfeeding/chestfeeding, they can express and discard their milk until their nipples are healed. Once their nipples are no longer cracked or bleeding, the HBV-positive person may fully resume breastfeeding/chestfeeding. Providers may need to refer patients for lactation support to learn how to maintain milk production and how to supplement with pasteurized donor human milk or formula while temporarily not breastfeeding/chestfeeding.
- Hepatitis B and a Healthy Baby – This slide set is an audio-visual educational tool that describes the importance of getting babies vaccinated against hepatitis B if a person is living with hepatitis B. The 13-page slide set uses simple language and has audio in: Mandarin Chinese, Hmong, Korean, and Vietnamese, as well as English. Tagalog, in the form of Taglish, is available in a written format only.
- Hepatitis B and Your Healthy Baby – This slide set is a 24-page visual-only educational tool for pregnant people living with Hepatitis B. The slide set explains the importance of getting babies vaccinated against hepatitis B to prevent transmission of the disease. The slide set is written in easy-to-understand English. This slide set is also available in a Spanish version.
- Center for Disease Control Patient Education Resources (fact sheets in multiple languages)
- National Institute of Health
- Department of Veteran Affairs
- Asian Liver Center
- Hepatitis B Foundation
- Immunization Action Coalition