April 1991 Hepatitis B: Still a Risk? Before the advent of AIDS/HIV, one About 1 to 2 % of those who get acute Gay men were urged to get vaccinated, but of the most serious health concerns facing Hepatitis B die as a result of severe illness. the relatively high cost, the already high rate gay and bisexual men was Hepatitis B. In approximately 90-95% of the cases of infection in the community, and the While the severity of the AIDS epidemic (including both those who develop acute developing AIDS epidemic helped prevent has taken attention away from Hepatitis B, illness and those without symptoms), the widespread vaccination. and the adoption of safe sex practices has infection resolves within six months. In Sexually active gay men, including slowed its spread, it remains an important these cases, a person will not have recur- those who practice safer sex, are still urged and little understood health problem ring Hepatitis B and is, in fact, immune to consider vaccination as a way to protect among gay men. from HBV (but can get other forms of themselves against HBV. The vaccine is a Hepatitis B virus (HBV) is a blood- Hepatitis). series of three shots administed over a six borne virus transmitted in the same way as However, around 5-10% of those in- month period. Talk to your health care HIV. If the blood or semen of an infected fected with HBV do not resolve the infec- provider about whether you should be person finds its way into the bloodstream, a tion, and they become carriers. There are tested and vaccinated for HBV. person may become infected. This can several implications to being a carrier, If you have any questions about HBV happen through needle sharing, unpro- including the ability to transmit HBV to and how itmay affect you,call the Vermont tected anal or vaginal sex, occupational other people, the possibility of continuing Department of Health at 1-800-244-7639. exposure among health care workers, and, attacks of hepatitis symptoms (usually with limited efficiency, through oral sex. called having “chronic active hepatitis”) But while the route of transmission is and an increased chance of serious long the same as HIV, the viruses behave quite term liver damage (including cirrhosis and differently in the body. While HIV has a liver cancer). long incubation period, HBV causes illness It is believed that a person who is a fairly quickly, usually from 2 to 4 months carrier can reduce his chance of illness and ' ' after infection. long term complications through good F0 r Confldennal Some studies estimated that by the health practices, especially by avoiding early l980’s, morevthan 80% of sexually alcohol and eating a well-balanced diet. active gay men in urban areas had been Regularcontactwithahealth careprovider infected with the HBV. Only about one- who can assess the degree of ongoing liver ' half of people who get HBV develop acute activity and damage is also important. N r m I O n illness after infection; the other half may Although the rate of new cases among have either very mild symptoms or no gay men has gone down dramatically since symptoms at all. the early 1980’s (from over30% of the new Those who become sick are frequently cases with a known source to less than dramatically ill. Among the symptoms a 15%), gay men are continuing to getHBV. person may have are: jaundice ( a yellow- Because of the carrier rate, there is a ing of the skin and whites of the eyes); urine significant population of gay men who turning a dark orange or coffee color; ex- were infected with Hepatitis B in the past treme fatigue; gastro-intestinal problems and who remain infectious. While safersex including vomiting, nausea, lack of appe- practices should protect against HBV in- tite, and stomach pains); fever; and pro- fection as well as HIV, there are many men nounced joint pain. who do not practice safer sex consistently. There is no treatment for HepatitisB or They may be as vulnerable to HBV as to the symptoms associated with it. Those HIV. who develop Hepatitis B are basically Studies show that HBV, while trans- advised to get plenty of rest, avoid alcohol mitted in the same way as HIV, is a much anddrugs (because of theirdamaging effect more infectious virus. This means that the on the liver), and drink plenty of water to chances of getting it from a single unpro- avoid dehydration. tected encounter with an infected person These symptoms can be caused by any are much higher than thechances of getting ofseveral things, including Hepatitis A, B HIV. And, because precautions are not i or C virus, Non-A/Non-B Hepatitis, other always foolproof (breaking condoms, infectious diseases affecting the liver, ex- etc.), the hardier HBV may be more able to C al I cessive alcohol consumption, and other infect a person. _ organic or artificial causes. Diagnosis usu- Unlike HIV. 8VflCCi|1€ exists f01'HBV- P ally involves a series of blood tests to deter- Originally introduced in the early 1980's, mine viral exposure and liver function, as the vaccine was developed largely through 1 -2- well as assessment of possible exposure the cooperation of the gay community. risks. where many of the early studies were done.