How Hepatitis B Is Often Spread Through Sex

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Hepatitis is inflammation of the liver, which can lead to problems with liver function. Hepatitis B is a viral infection of the liver causing hepatitis. The hepatitis B virus (HBV) is one of three common hepatitis viruses in the United States. The other two are hepatitis A virus and hepatitis C virus. Of the three viruses, hepatitis B virus is most likely to be sexually transmitted.

How is hepatitis B transmitted sexually?

The ways the common hepatitis viruses spread overlap somewhat. However, the main route of transmission—or spreading—is different for each of them. Hepatitis A primarily spreads through contaminated food or water. But it is possible to transmit it sexually. Hepatitis C mainly spreads through exposure to infected blood, such as sharing needles or needlestick injuries. Hepatitis B can also spread this way. However, the major route of hepatitis B transmission—or HBV transmission—is through sexual contact.

Sexual transmission of hepatitis B is very common because it occurs easily. In fact, it is the most common way adults become infected with hepatitis B in the United States. You can get hepatitis B by coming in contact with blood, semen, or vaginal secretions from an infected person. You are at risk of hepatitis B infection if you fall into the following risk categories:

  • Men who have sex with men

  • People who have other STDs (sexually transmitted diseases)

  • People who have unprotected sex

  • People whose sex partner has hepatitis B

  • People with multiple sex partners

Does hepatitis B cause symptoms?

Hepatitis B is a sexually transmitted disease, but once it enters the body it attacks the liver. Most adults do not have symptoms right after infection. So, it is possible to have hepatitis B and not know it. When symptoms occur, many people mistake them for a bad flu or stomach flu. This includes fever, fatigue, nausea, vomiting, loss of appetite, dark urine, and light or clay-colored stool. People may not realize these are symptoms of an infection they can spread sexually.

Jaundice, which is yellowing of the skin or eyes, can occur as well. This is because liver inflammation affects how your liver processes bilirubin, a yellow-orange-colored product from old red blood cells that are breaking down. With hepatitis, bilirubin builds up in the blood and part of it ends up in the skin and mucous membranes (including those of the eyes), causing them to turn a shade of yellow.

People can spread hepatitis B whether they have symptoms or not. The only way to know if you—or a sex partner—is safe is with a blood test.

Can hepatitis B infection be prevented?

Fortunately, hepatitis B is one of the few STDs that has a vaccine. Completing the vaccination series is the best and most effective way to prevent hepatitis B infection. If you are at risk for hepatitis B, talk with your doctor about the vaccine. You can also contact your local health department.

Until you are fully protected with the vaccine, you can take steps to safeguard yourself. Practice safe sex and wear gloves when cleaning up blood or giving first aid. Clean blood spills with bleach and water. The virus can survive outside the body and remains infectious for a week.

If you think you have been exposed to hepatitis B through sex, seek immediate medical care. You can decrease the risk of developing an infection if you get the vaccine within 12 to 24 hours of exposure. Along with the vaccine, you may also need HBIG (hepatitis B immune globulin). This shot contains antibodies against hepatitis B. It works short-term to help prevent infection or fight off the infection if it occurs. HBIG can also help prevent severe infection.

Can you get hepatitis B again?

Most adults will clear the virus after the initial infection and recover completely. After clearing the infection, your body will produce antibodies against hepatitis B. This will protect you from getting the infection again. A blood test can show if you have these protective antibodies.

Clearing the virus can take a long time. It is also possible to develop a chronic infection, which can eventually cause cirrhosis, liver failure, or liver cancer. The best option for avoiding hepatitis B is vaccination.

What other ways can hepatitis B be transmitted?

It is possible, but less common, for hepatitis B to spread in other ways. But HBV transmission still involves contact with infected blood or other bodily fluids.

People can catch hepatitis B from:

  • Exposure to open wounds or blood including direct contact and needlestick injuries

  • Personal items that may exposure you to infected blood, such as razors or toothbrushes

  • Sharing needles, syringes, or other IV (intravenous) drug paraphernalia

Babies are at risk when they are born to infected mothers. Healthcare providers and dialysis patients are also at risk due to potential exposure to infected blood. The vaccine and HBIG can also protect these people if a potential exposure occurs.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jun 3
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Hepatitis B. Mayo Foundation for Medical Education and Research.
  2. Hepatitis B Questions and Answers for Health Professionals. Centers for Disease Control and Prevention.
  3. Hepatitis B Symptoms. Hepatitis B Foundation.
  4. Sexual Transmission and Viral Hepatitis. Centers for Disease Control and Prevention.