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Hepatitis B, a potentially life-threatening viral liver infection, is a major global health problem. Viral hepatitis is increasingly becoming a cause of illness and death among people living with HIV.1,2


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Hepatitis B is a viral infection that attacks the liver, putting people at high risk of death due to Liver Cirrhosis (liver damage) and liver cancer.2
Hepatitis B infection is caused by the hepatitis B virus (HBV).2,3
This virus is spread, the same way as HIV; through contact with the blood, semen, or other body fluids of a person infected with Hepatitis B. When a person is infected with both HIV and HBV, this is called “HIV/HBV co-infection” and they should be treated for both infections.3
HBV can be a short-term (acute) or long-term (chronic) illness and without treatment, chronic HBV can cause liver cancer or liver damage that leads to liver failure.3


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Although some people with acute HBV don’t present with symptoms, some symptoms include:

  • Loss of appetite
  • Tiredness
  • Nausea or vomiting
  • Fever
  • Stomach pain
  • Dark urine
  • Joint pain
  • Yellowing of the skin or whites of the eyes (jaundice)

Most people with chronic HBV don’t show any symptoms for years, however liver function tests may be the first sign of chronic HBV infection.3


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HIV/HBV co-infected people progress faster to liver damage than those with HBV infection only.1
Chronic HBV is treated with antiviral medicines. The medicines work to help limit damage to the liver.3
People with HIV/HBV co-infection should be treated for both infections. Some HIV medicines, such as tenofovir, are effective at treating both HIV and HBV.2,3
The medicines assist with slowing down progression to liver damage and improving long-term survival.2 Treatment does not cure HBV in most people, but suppresses the virus.2 The medicines should therefore be continued long-term, to keep the virus under control.2
A doctor will choose the best combination of medicines suitable for each patient.3


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Hepatitis B infection is unusual in children because children are vaccinated against Hepatitis B.1


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The HBV vaccine is the mainstay of hepatitis B prevention.2 In South Africa, it is recommended that all infants receive 4 doses of the HBV vaccine (at 6 weeks, 10 weeks, 14 weeks, and at 18 months of age) to complete the immunisation schedule of the Road to Health Booklet.2,4
All HIV-infected people or those at risk of being infected, including healthcare workers, should have an HBV vaccine.1,2
The following precautions should be taken to reduce the risk of contracting Hepatitis B:3

  • Using condoms during sex
  • Don’t inject drugs and re-use needles or syringes
  • Don’t share razors and other personal items that may come in contact with another person’s blood
  • Ensure that all tattoo and body piercing instruments are sterile before use.


Speak to your doctor or pharmacist for further advice on your condition and the best treatment options for you.


  1. National Consolidated Guidelines for the management of HIV in adults, adolescents, children and infants and prevention of mother-to-child transmission. South African National Department of Health, February 2020.
  2. World Health Organisation (WHO) Hepatitis B Key Facts; [July 27, 2020]. Available from: Last accessed August 2020.
  3. AIDSINFO, National Institutes for Health (NIH). HIV and Hepatitis B [Last reviewed July 30, 2020]. Available from: Last accessed August 2020.
  4. Expanded Programme on Immunisation – EPI (SA) Revised childhood Immunisation schedule from December 2015. Available from accessed December 2019.

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