From the Guidelines
Yes, Hepatitis B virus (HBV) can be sexually transmitted, as it is efficiently spread through sexual contact, particularly during unprotected sex with an infected partner, as stated in the most recent guidelines 1. The virus is present in bodily fluids including semen and vaginal secretions, allowing transmission during sexual activity. The risk increases with:
- Multiple sexual partners
- Men who have sex with men
- Those with other sexually transmitted infections However, sexual transmission is just one way HBV spreads; it can also be transmitted through:
- Sharing needles
- From mother to child during childbirth
- Through exposure to infected blood Prevention methods include:
- Vaccination, which is highly effective and recommended for all sexually active individuals not already immune, as emphasized in 1
- Using barrier methods like condoms during sexual activity The hepatitis B vaccine typically involves 2-3 doses over 6 months and provides long-lasting protection. If you're concerned about exposure, getting tested is important as many people with HBV don't show symptoms but can still transmit the virus and may develop serious liver complications later, as highlighted in 1. Key points to consider:
- HBV is more infectious and more stable in the environment than other bloodborne pathogens, such as HCV or HIV, as noted in 1
- The primary risk factors associated with infection among adolescents and adults are unprotected sex with an infected partner, having multiple partners, men having sex with men, having history of other STIs, and injecting drug use, as stated in 1
- CDC’s national strategy for eliminating transmission of HBV infection includes prevention of perinatal infection through routine screening of all pregnant women for HBsAg and immunoprophylaxis of infants born to mothers with HBsAg or mothers whose HBsAg status is unknown, routine infant vaccination, vaccination of previously unvaccinated children and adolescents through age 18 years, and vaccination of previously unvaccinated adults at increased risk for infection, as outlined in 1
From the FDA Drug Label
Patients should be advised that treatment with entecavir has not been shown to reduce the risk of transmission of HBV to others through sexual contact or blood contamination. Avoid doing things that can spread HIV-1 or HBV infection to others. ... Always practice safe sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood.
HBV can be sexually transmitted. The FDA drug labels for entecavir and tenofovir disoproxil fumarate tablets advise patients to practice safe sex to lower the chance of sexual contact with HBV. This implies that HBV can be transmitted through sexual contact. 2 3
From the Research
HBV Transmission
- HBV can be transmitted through sexual contact, as stated in studies 4, 5, 6, 7, 8
- The virus can be spread through body fluids, including blood, semen, and vaginal fluids 7
- Sexual transmission of HBV is a significant problem in certain high-risk groups, such as:
Prevalence and Incidence
- Approximately 5% of the world's population has chronic HBV infection, with nearly 25% of carriers developing chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC) 7
- In the United States, an estimated 47,000 (95% confidence interval [CI], 27,000-116,000) or 38.2% of acute HBV infections between 2013 and 2018 were attributable to sexual transmission 8
- Among the US noninstitutionalized population, an estimated 817,000 (95% CI, 613,000-1,100,000) persons 15 years and older were living with hepatitis B, with an estimated 103,000 (95% CI, 89,000-118,000) infections or 12.6% attributable to sexual transmission 8
Prevention and Protection
- Hepatitis B vaccination is recommended for all children and adolescents, and all unvaccinated adults at risk for HBV infection, including sexually active individuals such as MSM, individuals with occupational risk, and immunosuppressed individuals 7
- Although HB vaccination can prevent clinical infections (hepatitis), it cannot prevent 100% of subclinical infections 7