Female sex workers

Hepatitis B

What is hepatitis B?

  • Hepatitis B is a very contagious STI that can make you seriously ill.  
  • This infection causes a serious inflammation of the liver.

 What causes hepatitis B?

  • Hepatitis B is caused by a virus.  
  • The virus is in the blood, sperm, pre-cum and vaginal fluid of infected people and can be transmitted in different ways.  
  • You can get the virus if infected blood, sperm or vaginal fluid comes into contact with a wound on your skin or the mucous membrane of your mouth, nose, eyes, anus or vagina.
  • You can catch this virus by having unsafe sex with a partner who is infected by the hepatitis B virus., or from a puncture with an infected  needle (for instance, in case of injections, piercings, tattoos or acupuncture). The use of an infected razor blade or tooth brush can also be a risk.
  • If a woman with hepatitis B becomes pregnant, she can infect the baby at the moment of the birth.  That is why in Belgium, pregnant woman are checked for hepatitis B. 

 What are the complaints?

An infection with hepatitis B can develop in 2 different ways:

  1. Acute : 2 to 6 months after the infection, the complaints can arise.  Tiredness, reduced appetite, nausea, a feeling like you have the flu, fever, pain on the right above the abdomen.  The white of the eye and the skin may become yellow (jaundice).  Urine can be dark and stools can be very pale.  The yellowness disappears after a few weeks but the tiredness can last weeks to months.
  2. Chronic : in 5 to 10 % of the cases the virus does not disappear and remains in your body your whole life long.  You carry the virus (often without complaints) and can infect others.  For a few of these carriers, the liver remains inflamed.  In the long term this may damage the liver and can increase the risk of developing liver cancer.

How can it be diagnosed?

  • Hepatitis B is diagnosed by means of a blood test, 4 to 6 weeks after an infection.

 Treatment

  • Most of the time hepatitis B cures spontaneously.  For the acute form you usually have to rest.  You are simply too sick to work.
  • If the hepatitis B virus stays in your blood for more than 6 months, a treatment with medicines may be necessary.
  • For the chronic stage you must see a specialist. You will get medicines which will limit the complaints.  Some people who are treated get better after a while.

It is important that you inform your doctor that you use medication or the pill.  Most medicines are broken down by the liver, but in case of an inflamed liver, this may cause problems. It is best to avoid the use of alcohol during the acute stage.

Protection against hepatitis B

  • Vaccination is the only way to protect you completely against hepatitis B.  After 3 injections you are protected for life.  The vaccine is good and safe.  Side effects rarely occur and are usually not serious.  After the injection you may have some muscle pain near the place of injection.
  • Hepatitis B is the only sexually transmitted disease for which you can be protected “in advance”. If you work in the erotic sector you can get a free vaccine from several organizations (Ghapro, Pasop, EspaceP)

Warning  partners

  • In case of an acute infection of hepatitis B you must inform your sex partners.  They can get a test and, if necessary, a treatment.
  • If your partner is not yet infected with hepatitis B, he or she can get a vaccine. Also the other members of the family (e.g. children) should be vaccinated.

Work advice

  • During an acute form of hepatitis B you can’t work anyway because you are too sick.  In any case, you may not have oral, vaginal or anal sex, not with a condom either, until the doctor told you that you are cured.
  • If you are a carrier, you must always use a condom for oral, anal and vaginal sex.  If you don’t do this, you can infect your sex partners!
  • If you keep working, you must be extra careful and take the appropriate precautions. 
  • Because hepatitis B is very contagious, it is recommended to look for  another job.