How you can take care of yourself

People who have chronic HBV infection need regular monitoring of their liver condition to determine whether their disease is progressing, whether treatment is needed, or whether a liver cancer is developing. Make sure you do the following:

• See your doctor for evaluation of your liver's condition once or twice a year. Certain blood tests need to be performed periodically to monitor your liver's health. Discuss with your doctor if you are a candidate for the medications interferon alfa-2b, lamivudine, or adefovir dipivoxil. These medicines are given to certain people with chronic liver disease.
   
• Discuss with your doctor about getting periodic ultrasounds, alpha-fetoprotein blood tests, or other studies to make sure there is no evidence of a developing liver cancer. Physicians may recommend different schedules for ultrasounds and blood tests depending on the patient's age, sex, ethnicity, age at which the infection was initially acquired, family history, HBeAg status, and liver enzymes. Usually, ultrasounds and blood tests are recommended every six to 12 months.
   
• Review with your physician all medications you take. Even some "over-the-counter" medications can injure your liver.
   
• If you are pregnant, tell your physician that you have chronic HBV infection. It is essential that your baby be given hepatitis B immune globulin (HBIG) and started on hepatitis B vaccine within 12 hours of birth.
   
• Avoid alcoholic beverages. Alcohol can damage your liver.
   

If your liver disease has progressed...

If your liver disease progresses, here are some extra precautions you should take:

• Get your yearly influenza vaccine. Patients with severe liver disease should also receive pneumococcal polysaccharide vaccine.
   
• Get vaccinated against hepatitis A. Hepatitis A can further damage your liver.
   
• Don't eat raw oysters. Raw oysters may carry the bacteria Vibrio vulnificus which can cause a serious blood infection in individuals with liver disease. Approximately 40% of these cases are fatal.

How to protect others from HBV infection

People can get HBV infection from you by coming in contact with your blood, serum, semen, or vaginal fluids. HBV has also been transmitted by human bites. Although HBV has been detected in low concentrations in other body fluids, including tears, sweat, urine, feces, and breast milk, these fluids have not been associated with transmission. Fortunately, HBV is not spread by sneezing or coughing, or from casual contact such as holding hands. Here are some important guidelines for you to follow so that others are protected:

• Tell your sex partner(s) that you are infected with HBV. Your sex partner(s) must see a physician for hepatitis B blood testing. If, according to the blood tests, your partner has never had hepatitis B, he or she should be vaccinated. After the series of three shots is completed, your partner needs to return to the doctor for blood testing to make sure the vaccine protected him or her. Use condoms until your partner is proven to be protected from HBV.
   
• Make sure all household members see their physicians for hepatitis B testing and vaccination.
   
• Tell your health care providers that you are infected with HBV.
   
• Cover all cuts and open sores with a bandage.
   
• Throw away used personal items such as tissues or menstrual pads in a bag so others will not be exposed to your blood.
   
• Wash your hands well after touching your blood or body fluids.
   
• Clean up your blood spills. Then reclean the area with bleach solution (one part regular household bleach to 10 parts water).
   
• Do not share toothbrushes, razors, needles for ear piercing, nail files, clippers, nail scissors, washcloths, or anything that may have come in contact with your blood or body fluids.
   
• Do not share food that has been in your mouth (e.g., chewing gum) and do not pre-chew food for babies.
   
• Do not share syringes and needles.
   
• Do not donate blood, plasma, body organs, tissue, or sperm.
   
• Know that if someone is exposed to your blood—be it a family member, a friend, or even a stranger—preventive treatment is available for that person. If the exposed person receives HBIG and starts the hepatitis B vaccine series within a few days, that person has an excellent chance of being protected from HBV!
   
• Learn more about hepatitis B so you can make the best decisions for yourself and provide the best protection for your family and friends.

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