What Men Should Know

Hepatitis

Hepatitis means "inflammation of the liver", and viral hepatitis is caused by a group of viruses (germs) that mostly affect the human liver.

The sexually transmitted ABC 

The ABC of Viral Hepatitis

  • Hepatitis means ‘inflammation of the liver’, and viral hepatitis is caused by a group of viruses (germs) that mostly affect the human liver
  • Men who have sex with men are at a higher risk for viral hepatitis
  • The main types of hepatitis are A, B and C
  • Each virus is different and can be prevented in different ways

Hepatitis A

What is it?

  • A virus that lives in the gut of humans and can be excreted in faeces (shit)
  • Even a tiny amount of faeces can spread infection. This may cause outbreaks of Hep A when an infected chef does not wash their hands after going to the toilet
  • Men who have sex with men are at risk of Hep A if they engage in rimming (oral to anal contact) 

How do I know if I have it?

  • Symptoms occur a few weeks after exposure
  • Adults who get infected with Hep A may develop severe symptoms
  • The classic symptom is jaundice (yellow eyes and skin, sometimes with dark urine and pale faeces)
  • Fever, nausea and right-sided abdominal pain may occur
  • A blood test can tell if you have been exposed to Hep A in childhood and if you are at risk of the disease

How do I get treatment?

  • Hep A usually clears up on its own after a month or two and has no specific treatment – drink lots of fluids, eat a special diet and rest
  • How do I prevent it?
  • If you’ve already had Hep A you cannot get it again
  • Get tested to see if you are at risk of the disease
  • Get vaccinated – the vaccine is safe and extremely effective in preventing Hep A, even if you are exposed again
  • If you have not been vaccinated, avoid any activities that might expose you to faeces, such as rimming, or not washing your hands after touching your partner’s anus

Hepatisis B

What is it?

  • Hep B is a sexually transmitted infection (STI), caused by a virus that lives in blood and possibly other fluids such as semen, urine and saliva, that can be transmitted during unsafe sex
  • Can also be spread through sharing injection drug equipment or even through sharing straws or banknotes when snorting recreational drugs
  • The virus can cause an acute infection lasting a short period, or may cause a lifelong infection leading to liver complications such as cirrhosis (liver scarring) or cancer
  • The virus is quite hardy and can survive for long periods outside the body in blood and other body fluids 

How will I know if I have it?

  • Symptoms occur between 1 and 6 months after exposure
  • Sometimes the infection causes no symptoms at all – you would only know if you have had it by doing a blood test
  • In other cases jaundice (yellow eyes and skin, sometimes with dark urine and pale faeces) may occur
  • Fever, nausea and right sided abdominal pain may also occur
  • About 10% of people who get Hep B become chronic (long-term) carriers of the virus
  • Chronic infection may lead to cirrhosis which requires ongoing medical treatment|

How do I get treatment?

  • Get screened for Hep B at your clinic
  • Hep B is potentially curable although achieving a full cure is not easy
  • Treatment may consist of injections of interferon or of tablets (the same tablets used to treat another common virus – HIV)
  • Hep B requires long-term management and monitoring to prevent later complications such as cirrhosis and cancer from occurring

If you have hepatitis B you can transmit the illness to your sexual partners if there is any transfer of even tiny amounts of blood, semen, saliva or urine. 
Always use a condom if you are Hep B positive and ensure that your regular sex partner is vaccinated!

How do I prevent it?

  • Get tested to see if you have already been exposed to this virus
  • Get vaccinated – the Hep B vaccine is safe and extremely effective in preventing infection 
  • If you are unsure if you have been vaccinated, your doctor can do a blood test to see if you need a booster
  • Using condoms for anal sex may prevent transmission of Hep B but this is not 100% effective – your best option is to get vaccinated!

Hepatitis C

What is it?

  • A virus that lives in the blood and causes liver damage, spread mainly through sharing drug-taking equipment such as syringes and needles, and non-injection drug equipment such as straws and banknotes used to snort drugs
  • Hep C is spread during sex among men having sex with men – it can be transmitted via unprotected anal sex, sharing of sex toys or engaging in other extreme sex acts such as fisting
  • Hep C is still relatively uncommon in South Africa but infection rates may be increasing
  • Hep C may cause a chronic (long-term) infection which is not curable
  • There is no effective vaccine against Hep C

How do I know I have it?

  • Often this infection causes no symptoms and goes unnoticed – you will only know if you have been exposed if you have a blood test
  • If symptoms occur they are very similar to hep B (see above)
  • Have a blood test if you are unsure of being exposed

How do I get treatment?

  • Hep C is often not curable and treatment is difficult and costly, but the disease can be managed to limit the damage and complications it causes

How can I prevent it?

  • Avoid sharing drug-taking equipment, intravenous or otherwise
  • Use a condom for anal sex
  • Use condoms on sex toys and wash them thoroughly between use
  • Use gloves for any hand-to-anal contact during sex
  • There is no vaccine for Hep C so avoidance is the only method of prevention