Hepatitis B and your cancer risk

Along with hepatitis C, which also attacks the liver, hepatitis B is a leading cause of liver cancer in the United States. So knowing your risk, getting vaccinated and getting screened are important steps to reduce your risk for liver cancer.

Chronic hepatitis B can wreak havoc on your liver, but you probably won’t know it’s happening.

Hepatitis B is a viral infection that attacks the liver. Usually in the first six months, adults may have mild symptoms that are easily ignored or no symptoms at all. Children typically do not have symptoms, either. If your body does not clear the virus, it becomes a chronic infection that can stay in the body for decades, causing damage with no symptoms at all.

“When patients find out they have chronic hepatitis B, they are often surprised,” says Jessica Hwang, M.D., associate professor in Internal Medicine. “Because it’s so quiet, stealthy and lingering, it can cause damage and the patient might not know about it until very, very late.”

Who is at risk for hepatitis B?

Hepatitis B is spread through contact with infected blood and body fluids. You cannot get hepatitis B through casual contact like kissing, hugging or sharing eating utensils. It cannot be spread through coughing or sneezing.

“There’s a lot of misconception about how the virus is spread, and confusion with other strains of hepatitis that are spread in different ways,” says Hwang. “It’s really through blood or body fluid.”

You are at increased risk for hepatitis B infection if you:

• Were born outside the United States in a region with high infection rate
• Have sexual contact with a person with hepatitis B
• Share items such as razors or toothbrushes with an infected person
• Have used intravenous drugs, even once or in the distant past
• Have multiple sexual partners or history of sexually transmitted disease
• Are a man who has had sex with another man
• Are exposed to blood on the job
• Had an organ transplant or blood transfusion prior to 1992
• Received clotting factor concentrates produced before 1987
• Have a history of chronic liver disease, diabetes, HIV or AIDS
• Are undergoing renal dialysis

Women who are pregnant should be tested for hepatitis B infection to prevent infecting their baby.

How to prevent hepatitis B

Get vaccinated. The best form of protection is to get vaccinated for hepatitis B. The vaccine can be given to infants, children and adults. Anyone who is at increased risk should be vaccinated.

“All newborns are now vaccinated,” says Hwang. “However, if you were born before 1980, when vaccinating newborns became standard, you may not be protected.”

In adults, the vaccine is given in two doses, about 4-6 months apart. In infants and children, three doses is recommended.

Get screened. The screening exam for hepatitis B is a simple blood test. If you do have the virus, it can be managed with medication, and you can take steps to protect yourself from liver damage. Getting screened also protects family members.

“Early testing is crucial for reducing the spread of hepatitis B,” Hwang says. "Patients who are aware they are infected can take precautions to protect those around them, and family members can be alerted that they should be vaccinated.”

If you have hepatitis B

If you are infected, take steps to protect your liver.

The most important thing to reduce your risk of developing liver damage and liver cancer, says Hwang, is to follow your doctor’s treatment recommendations. Get regular check-ups to monitor the amount of virus in your body and the condition of your liver, and take your medicine.

“Hepatitis B can be treated with oral, daily medications that reduce the amount of virus in your body,” she says. “Managing your infection will help lower your risk for liver damage and, in the long term, liver cancer.”

Talk to your doctor about any over-the-counter medications – like acetaminophen – that can hurt the liver. That includes nutritional supplements that claim to be beneficial to the liver, but may actually be harmful to it.

It’s also important to make healthy choices that reduce your risk for cancer. Aim for a diet with lots of vegetables and fruits, and avoid drinking alcohol.