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About Hepatitis B and Home Testing

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What is Hepatitis B?

Hepatitis B is a virus that affects the liver.

  • Most adults who get hepatitis B will clear the virus after a few weeks or months because their immune system fights it off.
  • Early hepatitis B is called acute hepatitis B. Some people will feel unwell, and some may get jaundice (the skin and eyes turn yellow). Most people will have no symptoms or mild symptoms.
  • For some people, hepatitis B does not clear and stays in the body for a long time. When hepatitis B lasts longer than 6 months it’s called chronic hepatitis B. If it’s not managed and monitored, it can sometimes cause serious, life-threatening liver damage.

How is hepatitis B transmitted?

Hepatitis B is usually transmitted (passed on) when the blood of someone with hepatitis B gets into the blood of someone without hepatitis B. It can also be passed on in semen (cum) and vaginal fluids.

It can be passed on:

  • During vaginal or anal sex without a condom
  • During oral sex without a condom or dam, but the chance of transmission is lower than for vaginal or anal sex
  • By sharing drug injecting equipment
  • From unsterilised tattoo or piercing equipment
  • By sharing items like razors, toothbrushes or hair clippers that may have blood on them – but this is uncommon
  • If you’re hurt by a used needle

If you’re pregnant and have hepatitis B, it’s possible for the virus to be passed on to the baby. Getting diagnosed and treated can stop this happening.

Hepatitis B vaccination

  • A free hepatitis B vaccination can help protect you if you have a higher chance of getting hepatitis B. The hepatitis B vaccine is safe and effective.
  • It’s usually given in 3 doses, with 1 month between each dose, plus a 4th dose 12 months after the first. It may also be given as 3 doses over 21 days, with a 4th dose sometimes needed 12 months later.

The following individuals may be considered for hepatitis B vaccination:

  • People living with HIV or hepatitis C
  • Gay, bisexual or other men who have sex with men
  • Trans people who have sex with men
  • Anyone with more than 1 sexual partner in the last 3 months
  • People who share needles, syringes, or other drug-injection equipment. This includes people who inject steroids and ‘recreational’ drugs and anyone who injects or smokes crack cocaine
  • Sex workers
  • People requesting PEP or PrEP to prevent HIV infection
  • Survivors of a recent sexual assault
  • People from (or with a sexual partner from) a country where hepatitis B is common (outside of Western Europe, North America and Australasia)
  • People with chronic liver disease or kidney disease
  • People who have close household contact with someone living with hepatitis B virus or someone with a higher chance of acquiring hepatitis B
  • Prisoners
  • People detained at an immigration centre
  • Healthcare and public safety workers at risk of exposure to blood, or body fluids containing blood, on the job
  • Travellers to regions with moderate or high rates of hepatitis B
  • Anyone with an STI that needs treatment

What are the symptoms of hepatitis B?

Many people with hepatitis B do not get any noticeable symptoms.

If symptoms do appear, they can often be mistaken for flu or another illness.

Any symptoms usually appear around 3 months after getting hepatitis B, but it can be earlier or later.

Symptoms may include:

  • High temperature
  • Tiredness
  • Feeling or being sick
  • Appetite loss
  • Tummy pain
  • Itchy Skin
  • Jaundice (yellow colour in the skin and eyes; you may have dark wee and pale poo)

Symptoms usually go away without treatment after a few weeks or months because the body fights off the virus.

Sometimes the immune system cannot fight off the virus and hepatitis B lasts longer than 6 months – usually for life. This is called chronic hepatitis B.

Some people with chronic hepatitis B may have ongoing symptoms but most have no symptoms for many years. Hepatitis B can still be passed on to other people during this time.

Only about 1 in 20 adults who get hepatitis B will develop chronic hepatitis B. In contrast, most babies that get hepatitis B don’t clear the virus and have chronic hepatitis B through their life. This is especially common in people who were born in, and grew up in, areas of the world where hepatitis B is much more common. This includes Africa, Asia, the Middle East, parts of South America and Eastern Europe, the Caribbean and the Pacific Islands.

Can hepatitis B cause health problems?

In some people, liver damage caused by chronic hepatitis B can eventually lead to life-threatening conditions, such as cirrhosis (scarring of the liver) or liver cancer. Most people with chronic hepatitis B will not get cirrhosis or liver cancer.

Hepatitis B testing in London

The types of hepatitis B tests commonly used can tell whether you:

  • have acute or chronic (active) hepatitis B infection
  • have recovered from hepatitis B – meaning you’ve cleared the virus and are naturally immune
  • have not been exposed to the virus and are not immune – meaning you may benefit from vaccination to protect you from acquiring the virus if you’re exposed in future
  • are immune to hepatitis B because you’ve been vaccinated

An SHL hepatitis B screen can test for the first 3 possibilities. At the moment, we don’t test to see if you’re immune to hepatitis B due to vaccination. You’ll need to get a test at a sexual health clinic or GP surgery to check this.

Because many people with hepatitis B don’t notice any symptoms, we make it easy for Londoners to get a free hepatitis B test if you might have been exposed to hepatitis B.

Order your free postal testing kit online, take a blood sample, post it to our lab, and get your results in a few days.

If your SHL test comes back reactive, suggesting current hepatitis B infection, the SHL Health Adviser team will refer you to a sexual health clinic for blood tests that can confirm if you have an active hepatitis B infection.

If these blood tests confirm active hepatitis B, you’ll be referred to a specialist hepatitis clinic for ongoing care and management.

Free STI Testing Kit

Test for common STIs. Get your free NHS-funded STI test kit delivered to your door in London.

Take a self-sample at home and return it for free. Get your results online within a week.

Access SHL free services now

How is hepatitis B treated and managed?

Most adults with acute hepatitis B can fight it off without treatment. This can be in a few weeks or can take a few months.

During this time, it can help to:

  • Get plenty of rest
  • Drink plenty of water
  • Eat a healthy, balanced diet
  • Avoid alcohol and recreational drugs to help your liver get better
  • Keep cool and wear loose clothes if you have an itchy rash

You may be offered painkillers or medicine to stop you feeling sick and may be offered a check-up with a liver specialist.

If you have chronic hepatitis B:

  • You may be offered antiviral medicine and medicine to help with any symptoms, but not everyone needs treatment
  • Treatment can’t always cure chronic hepatitis B but can help to manage it
  • You’ll need to see a liver specialist for regular check-ups. This may include regular blood tests, ultrasound scanning of the liver, or a non-invasive assessment for fibrosis
  • Your liver specialist will discuss the best ways to manage the virus
  • You’ll usually be advised to cut out or limit alcohol because it can cause more liver damage

Always check with your specialist or another healthcare professional before you take any type of new medicine or supplement. This is in case they could affect your liver

Do I need to tell my sexual partners?

If you have hepatitis B, you’ll usually need to tell current and previous sexual partners and anyone who you’ve shared drug injecting equipment with.

Previous sexual (or injecting) partners will be offered hepatitis B testing and may be offered hepatitis B vaccination.

If your last sexual or injectable contact with someone was very recent, they may be offered hepatitis B immunoglobulin. This is a treatment that can help prevent someone from acquiring hepatitis B.

Informing, testing and treating partners is really important because it lowers the chances of:

  • Hepatitis B causing serious liver damage in a partner
  • Hepatitis B being passed on to a partner’s other partners

If you feel unable to tell sexual partners, one of the SHL team can tell them without mentioning your name.

Taking care of your sexual health

Most people will not get hepatitis B again – but you can still get other types of hepatitis.

If your body fights off hepatitis B, you’ll usually become immune to it. However, in some people with a weakened immune system, the hepatitis B may come back and may need treatment.

Even though most people will not get hepatitis B again, you can still get other types of hepatitis such as hepatitis C.

If you do have hepatitis B, you may also have other infections. It’s advisable to have a full sexual health screen, including tests for chlamydia, gonorrhoea, HIV, syphilis and hepatitis C.

You’ll usually be offered free a hepatitis A vaccine and a test for hepatitis D.

People living with hepatitis B are advised to:

  • Avoid or limit alcohol because it can cause more liver damage
  • Check before taking any prescription pills, supplements, or over-the-counter medications, as these can potentially affect the liver

You can’t usually donate organs, blood or sperm after having hepatitis B, even if you clear the virus and become immune.

If you do not have hepatitis B, but you’re at higher risk of getting it in the future, vaccination can help prevent this. See the hepatitis B vaccination information above.

To help protect your health in future:

  • Use condoms
  • Do not share injecting equipment
  • Encourage sexual partners to test for STIs

If you’re sexually active, consider testing for STIs at least once a year and after a change in partner. You don’t usually need to get tested if:

  • you have just one long-term partner and
  • you only have sex with each other and
  • you’ve both tested for STIs since you’ve been together.

Anyone who lives in an area covered by SHL can have up to 4 free STI testing kits a year.

If you’re HIV negative, you may benefit from an HIV prevention medicine called PrEP. This can also reduce your risk of hepatitis B.

If you have a higher chance of getting syphilis or chlamydia you may be offered doxyPEP. This is an antibiotic you take soon after sex to lower your chance of getting chlamydia or syphilis. Ask your local clinic if doxyPEP is suitable for you.

Related Pages:

More information about hepatitis B

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FAQs about free NHS hepatitis B tests in London

Get answers to some common questions.

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Why should I take a free hepatitis B home self-sampling test?

Hepatitis B is more common in London than in most other parts of the UK. Many people with hepatitis B will not have any symptoms, so you could have it without knowing.

Hepatitis B can easily be passed on to sexual partners or through blood-to-blood contact.

If the body’s immune system cannot fight off the hepatitis B virus it can eventually lead to life-threatening liver damage.

Detecting hepatitis B early so it can be managed is the best way to help stop any serious damage.

Who should do a hepatitis B home self-sampling test?

Anyone can get hepatitis B, but some people have a higher chance of acquiring it. This includes people who inject drugs, people who often change sexual partner, and gay, bisexual or other men who have sex with men.

Hepatitis B testing will soon be provided to everyone having an STI screen with SHL for the first time. After this, if you order further STI test kits we’ll ask you a few questions to check if you could be at higher risk of hepatitis B. If so, we’ll offer further testing for it.

If you’re sexually active, it can be a good idea to test for STIs at least once a year or after a change in partner, especially if you have sex without a condom. Some people may be advised to test more often.

You don’t usually need to get tested if:

  • you have just one long-term partner and
  • you only have sex with each other and
  • you’ve both tested for STIs since you’ve been together.

When should I take a hepatitis B home self-sampling test?

Order a free STI testing kit now if:

  • you have symptoms that could be hepatitis B
  • you feel you’ve been at high risk of hepatitis B
  • a sexual partner has hepatitis B or another STI

Order an STI self-testing kit now.

Depending on your symptoms, we may suggest you get tested at a sexual health clinic instead of using a home self-sampling kit.

SHL will assess if you need hepatitis B testing by asking you certain questions when you place a kit order. Call the SHL team if you feel you need hepatitis B testing and it hasn’t been recommended.

Hepatitis B may not show up on a test straight away. Testing too early may mean you test negative even if you do have early hepatitis B. Consider retesting 3 to 6 months after your last sexual contact to make sure your test is as accurate as possible.
More about when to take a test.

If you want to get tested at a sexual health clinic instead, search for your nearest London sexual health clinic.

How do I order a free hepatitis B test kit?

Hepatitis B testing will soon be provided to everyone having an STI screen with SHL for the first time. After this, if you order further STI test kits we’ll ask you a few questions to check if you’ve been at risk of hepatitis B. If so, we’ll offer further testing for it.

Londoners can order a free STI testing kit online. Your kit should arrive by post in the next few days.

  • Answer some online questions – your answers are confidential
  • We’ll work out whether you need hepatitis B testing and which tests are best for you
  • Your free STI test kit arrives by post in the next few days – in a discreet plain package

If you want to get tested at a sexual health clinic instead, search for your nearest London sexual health clinic.

How do I use my free hepatitis B self-sampling test kit?

Your testing kit comes with all you need to take your own sample. This is called self-sampling.

A self-sampled hepatitis B test is done with a simple finger-prick blood test. You need a very small amount of blood – less than 1 millilitre.

Pack your samples into the freepost box and send them back to our lab for testing. Post them in any Royal Mail postbox.

When will I get my hepatitis B test results?

You’ll usually get your results 2 or 3 days after your self-sample arrives at our lab.

You’ll be able to view the results online. They’re completely secure and private.

Order your STI testing kit now to get your results as soon as possible.

What do my hepatitis B test results mean?

An SHL hepatitis B screen can include a number of specific tests for hepatitis B. These can tell whether you:

  • Are likely to have hepatitis B now
  • Had hepatitis B in the past, but not anymore
  • Have never had hepatitis B

Reactive result

Depending on the types of hepatitis B test SHL performs on your blood sample and their results, you may be told you’ve tested reactive for hepatitis B. This is sometimes called a positive result. It means you may have hepatitis B now, but you need further testing to confirm if you have an active infection.

You’ll be advised to go to a clinic for a blood test to confirm if you have hepatitis B now. If this confirms active hepatitis B, you’ll be referred to a specialist hepatitis clinic for ongoing care. This may also include treatment.

Negative result

This means hepatitis B was not detected.

It can take up to 3 months before hepatitis B shows up on a blood test. If it’s been less than 3 months since you could have been exposed to hepatitis B, it’s advisable to test again later to check you still get a negative result.

If you test negative for hepatitis B, our SHL team will advise whether you could benefit from a hepatitis B vaccination.

Immunity

An SHL home hepatitis B test can’t tell if you’re immune to hepatitis B due to vaccination. A blood test at a sexual health clinic or GP surgery can tell you if you’re immune. SHL is planning to offer this test in future.