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Men who
have sex with men (MSM) are at increased risk of becoming infected
with both the hepatitis B virus (HBV) and the hepatitis A virus (HAV).
Although these viruses can be transmitted in different ways, both
can be spread through sexual activity.
Hepatitis is a serious disease that can be fatal. Fortunately, both
hepatitis B and hepatitis A can be prevented by safe and effective
vaccines. Unfortunately, many men at risk remain unprotected.
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What is hepatitis B?
Hepatitis B is a sexually transmitted disease caused by a virus (HBV) that attacks the liver. The virus is found in the blood and semen of infected men and is spread in the same manner as HIV. HBV is easier to catch than HIV because it is more than 100 times more concentrated in an infected person's blood and can exist on surfaces outside the body.
What is hepatitis A?
Hepatitis A is a liver disease caused by a virus (HAV). The virus is found in the feces (shit) of an infected person. It is easily spread by household or sexual contact with an infected person.
 How great is my risk of getting HBV or HAV infection?
About 5% of people in the U.S. will get infected with HBV sometime during their lives. MSM are 10 to 15 times more likely to acquire HBV infection than the general population.
In 2001 an estimated 93,000 persons in the U.S. were infected with HAV. Persons who engage in anal pleasuring activities such as rimming and fingering are at increased risk.
How are HBV and HAV spread?
An HBV-infected man can spread the virus to another person by
- having unprotected anal or vaginal sex
- sharing needles for drugs, piercing, or
tattooing
- coming in contact with the infected
person's open sores or blood
- sharing toothbrushes, razors, nail
clippers, etc.
- biting another person
HBV can also be spread by living in a household with a chronically infected person.
HAV is usually transmitted from particles of fecal material too small to be seen,
for example,
by eating or drinking contaminated food or water or during sex.
What are the symptoms of hepatitis B and hepatitis A?
The symptoms of both diseases are similar: extreme tiredness, nausea, fever, dark urine, bloated and tender belly, and yellowish-tinged skin and eyes. Infected persons can have no symptoms at all or be extremely ill. However, people who are infected with either HBV or HAV can spread the disease to others, whether they have symptoms or not.
Do people fully recover from HBV and HAV infections?
Most adults recover from HBV infection after several months and are no longer contagious. Unfortunately, about 2%-6% of adults who become infected with HBV will carry the virus in their bodies for years and remain infectious. Chronically infected people usually do not have symptoms, but are at increased risk for eventual liver failure (cirrhosis) and liver cancer and need ongoing medical care. About 1.25 million people in the U.S. (and 350 million in the world) are chronically infected.
Although HAV does not result in chronic infection, infected people can become very sick and sometimes die.
How serious are HBV and HAV infections?
HBV infection can cause serious liver disease, including liver failure and liver cancer. More than 5,000 people in the U.S. die every year from hepatitis B-related liver disease.
There are approximately 100 deaths each year in the U.S. from hepatitis A. About 15% of people with hepatitis A require hospitalization. Adults who become ill are often out of work for several weeks.
Becoming infected with HBV or HAV can have a major impact on a person's life. A person might be too sick to work or go to the gym for months, and should not drink alcohol. HAV and HBV infection can have serious consequences for people with HIV, as their immune systems might be compromised.
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How can I protect myself from HBV infection?
- Get the hepatitis B shots
- Practice safer sex
- Tell your friends at risk to get
vaccinated against hepatitis B
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How can I protect myself from HAV infection?
- Get the hepatitis A vaccine
- Tell your friends at risk to get
vaccinated against hepatitis A
How do I know if I have or have had HBV or HAV infection?
The only way to know for sure is to have your blood tested.
Should I have my blood tested before getting vaccinated?
Discuss this with your doctor to decide if it is appropriate to perform blood tests first. If you have already been infected with HAV or HBV, getting the vaccines will not help or hurt you.
How many shots do I need to be protected against HBV and HAV infections?
The hepatitis B vaccine series consists of three doses spaced out over approximately 6 months.
The hepatitis A series consists of two doses
given 6-18 months apart. If you started either series but didn't get all the doses, you should continue where you left off.
A combined hepatitis A and hepatitis B vaccine has been developed for adults who need protection against both HAV and HBV infections. This vaccine consists of three doses given over a 6-month period.
Are these shots safe? Do they have any side effects?
Both hepatitis A and hepatitis B vaccines have been proven to be safe. Globally, more than one billion hepatitis B vaccine doses have been given. Since 1995, more than seven million doses of hepatitis A vaccine have been given in the U.S. with no reports of serious health problems linked to the vaccine. Side effects might include soreness at the injection site, headache, and fatigue.
Are these shots effective?
Yes. After three doses of hepatitis B vaccine, at least 90% of healthy young adults develop immunity to HBV infection. Immune compromised people might not respond as well to hepatitis B vaccine. They should be tested 1-2 months after the third dose of vaccine to see if they responded.
Almost 100% of people are protected from HAV infection after getting two doses of hepatitis A vaccine.
Will hepatitis A or hepatitis B vaccine protect me from
hepatitis C?
No. Hepatitis A, B, and C are all different viruses. The hepatitis C virus is spread through body fluids, and although it can be transmitted through sexual contact, it is most commonly acquired through injection drug use. Unfortunately, there is no hepatitis C vaccine at this time.
Are these shots recommended for travelers?
Both HAV and HBV infection are common in many parts of the world. People traveling to any area of the world except the United States, Canada, Western Europe, Japan, New Zealand, and Australia should get vaccinated against HAV. Hepatitis B vaccine is recommended for many travelers also. Discuss this with your doctor.
Where can I receive these shots?
Talk to your health care professional or your local public health department.
Clinics offering free or low-cost hepatitis A and hepatitis B vaccines for gay and bisexual men are listed at
www.hepclinics.com and
www.hepprograms.org/msm
The Immunization Action Coalition (IAC) encourages you to make and distribute copies of this brochure. If you alter it, please acknowledge that it was adapted from IAC. This brochure was developed in collaboration with Levine & Co., NYC. The technical content was reviewed by the Centers for Disease Control and Prevention.
Item #P4115 (4/04)
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