Arm yourself against Hep B! Vaccinate

Arm yourself against Hep B! Vaccinate

Arm yourself against Hep B! Vaccinate Written by Injecting Drug Users for Injecting Drug Users Why it s important for injecting drug users to know about and understand hepatitis B? Basically, the hepatitis B virus (hep B) attacks the liver. Hep B is both a blood borne virus and a sexually transmitted infection. It is very important to try to maintain the best liver health possible because the liver plays so many important functions in the body, including breaking down all the drugs we take. Most current drug users take a variety of substances that make the liver work harder; alcohol, benzos, grass, and ciggies, not to mention the cutting agents in the drugs we inject. It may be difficult to avoid these other liver stressors but you can vaccinate against the hep B virus so it doesn t damage the liver further. A safe vaccine has been available since 1982. The vaccine provides protection against the hep B virus if you ever come into contact with it in your day to day life. Many injecting drug users (IDU) have hepatitis C (which also attacks our livers). There is no vaccine for hepatitis C. If you have both hep B and hep C it is called co-infection and is discussed later.

What is the hepatitis B virus? Hepatitis B was first identified in 1965 and named the Australia Antigen as a result of its discovery in Aboriginal and Torres Strait Islander people. It is estimated that in Australia around 165,000 people have chronic hepatitis B. Hepatitis B is transmitted through blood, semen and saliva. Hepatitis B is spread by: Unsafe injecting practices; sharing equipment etc, Unprotected sexual contact; not using condoms, Sharing personal items such as toothbrushes, razors and nail scissors with a person who has hep B, Uncleaned or reused tattoo/piercing items; such as needles and inks, and Being passed from mother to baby. Hepatitis B is not spread by: Contaminated food or liquids, Sharing food, drinks or cutlery; or Hugging, kissing, sneezing and coughing. Symptoms of hepatitis B Acute hepatitis B infection occurs 4 12 weeks after exposure to the virus in most people, but sometimes it can take longer. It can be symptomatic (you feel the symptoms) or asymptomatic (you may not know you have the disease because you don t have symptoms). Symptoms of acute hepatitis B virus infection (these will usually last 4-12 weeks after onset) can include: Anorexia, Dark urine and pale poo, Jaundice yellowing of eyes and skin, Nausea and vomiting, Muscle and joint pain, and Pain or discomfort in the upper right side of the abdomen. Given the risks many of us take, asymptomatic hepatitis B is a big concern for injecting drug users. If your doctor is testing you for anything else, it s a good idea to ask them to test for hepatitis B as well. If you find that you don t have it and aren t immune then it s time to consider vaccination.

Symptoms of chronic hepatitis B infection Chronic infection is defined if you have remained HBsAg (surface antigen) - positive for more than 6 months. Most people have no symptoms from the hepatitis B at all, while others may have occasional periods of feeling the following symptoms: Depression and or anxiety Pain or discomfort in the upper right side of the abdomen; Loss of appetite, Vomiting and nausea; and Joint aches Injecting drug users need to be careful not to put these symptoms down to feeling a bit off, hanging out and/or hepatitis C infection, when in doubt get tested. Understand your hepatitis B test results To find out if you have the hepatitis B virus a blood test needs to be taken. Your blood will be analysed for bits of the hepatitis B virus, these bits include antigens or proteins that make up different parts of the hepatitis B virus, and antibodies which your immune system generates to fight those antigens. Antigen a substance foreign to the body like the hepatitis B virus. Antibody a protein the immune system makes to fight a foreign substance. These tests are quite complicated so use the table below as a guide only; speak with your doctor so she/he can tell you what the results mean to you personally. Test Short Form Its meaning Hepatitis B surface antigen Hepatitis B surface Hep B e antigen Hepatitis B e Hepatitis B core Hepatitis B Virus DNA HBsAg HBsAb or Anti HBs HBeAg HBeAb or Anit HBe HBcAb or Anti HBc HBV DNA Hepatitis B Vaccination Its presence means a person is infected with hepatitis B. It is found during both acute and chronic stages Its presence means the person has developed immunity to hepatitis B. This means the hepatitis B virus is actively replicating and is associated with a higher degree of infectiousness. This means the immune system has partially controlled the virus and replication is reduced but active liver disease can still occur. This is positive in anyone who has even been infected with hep B, whether they have cleared the infection or are chronically infected This tells you how much of the hepatitis B virus is in the bloodstream and how quickly it is replicating The hepatitis B vaccine has been available since the 1980s and all children born in Australia are now given the vaccine with their other childhood vaccinations. A school-based program targets children who were not vaccinated as newborns and are now aged 10-14 years old but a significant number missed out on this program. For adults, a course of three intramuscular injections over a period of six months is needed.

Access to hepatitis B vaccine for IDU by State/Territory All childhood hepatitis B vaccinations are subsidised by the Government. Hepatitis B vaccine is free to all IDU as we are considered an At Risk Group. You should be able to get the vaccine free, however if you can t, ring your local user group and get them to look into it. State/Territory South Australia Northern Territory New South Wales Western Australia Access to Hepatitis B Vaccination Free to injecting drug users (IDU) Free to IDU at Sexual Health Clinics Free to HIV and hepatitis C positive IDU who are clients of doctors with S100 prescribing rights also at Sexual Health Clinics and all Opiate Treatment Programs Free to IDU if diagnosed with hepatitis C also at Western Australian Substance Users Association (WASUA) and the Street Doctor Co-infection with hepatitis C It is believed 4-6% of hepatitis B antigen positive HBsAg people are co-infected with hepatitis C. It is common for IDU with hepatitis C co-infection to have a reduced replication of the hepatitis B virus. This is because hepatitis C directly interferes with replication of the hepatitis B virus. Chronic hepatitis B and hepatitis C co infection is usually associated with: more severe liver disease, increased risk of progression to cirrhosis; and a higher incidence of Hepato-cellular carcinoma (cancer of the liver) Often doctors will just test for hep C (it s the virus getting all the attention at the moment) and forget about hepatitis B. Ask your doctor to order tests for both hep B and hep C. The message is to get tested. If you do not have hep B get vaccinated. Protect Yourself Victoria Queensland ACT Tasmania Free for all IDU and available at Sexual Health Clinics Free for all IDU and available at all Sexual Health Clinics, Alcohol and Drug services Free to all clients of the ACT Alcohol and Drug Program and available at Sexual Health Clinics Free to IDU at Sexual Health Clinics