Hepatitis A, B, and C

Hepatitis is a viral infection that attacks the liver and causes inflammation.

There are different types of hepatitis. In Aotearoa New Zealand, the most common types are hepatitis A, hepatitis B, and hepatitis C.

Many people with hepatitis don’t have symptoms and don’t know they are infected. 

Do I need an STI test?

Hepatitis A is an infectious liver disease caused by a virus.

It’s rare in Aotearoa New Zealand, but more common overseas in developing countries. Unlike other types of hepatitis, most people with hepatitis A have symptoms – but they’re usually mild.

You can get hepatitis A from water or food that has been contaminated by sewerage or human poo, or by injecting drugs. You can also get hepatitis A from mouth on anus contact, such as during sex. 

Hepatitis B is an infectious liver disease carried in blood or other body fluids.

Previously it was common in Aotearoa New Zealand until a free vaccine was introduced in the 1980s. 

You can get hepatitis B from having unprotected sex. This includes vaginal sex, anal sex, or oral sex without external or internal condoms or oral dams. 

You can also get hepatitis B from sharing items that pierce your skin or have blood on them. This includes razors, toothbrushes, or needles used for injectable drugs or unsafe tattoos. 

Sometimes called “hep C” for short, hepatitis C is an infectious liver disease carried in blood. 

You can get hepatitis C by having unprotected anal sex (sex without condoms). But it's more common to get it from sharing items that pierce your skin or have blood on them. This includes razors, toothbrushes, or needles used for injectable drugs or unsafe tattoos.  

Sometimes hepatitis C can be passed on during unprotected vaginal sex (sex without condoms) – this is more likely if you're having rough sex.  

Many people with hepatitis will show no symptoms.

Even if you have no symptoms, you can still spread the virus to others. That’s why it’s important to get STI tests regularly. 

If you do have symptoms of hepatitis, they might include: 

• Yellowing of the skin and the whites of the eyes  
• Dark coloured pee/mimi   
• Pale coloured poos   
• Mild flu-like symptoms  
• Stomach pain  
• Nausea and vomiting

You can get tested for hepatitis with a blood test at a laboratory.

Some people with hepatitis have very mild symptoms or no symptoms at all. But it is important to get tested for STIs regularly to keep yourself, your partners or sexual contacts, and your whānau/family healthy. Testing for hepatitis is only recommended for some people. Your nurse or doctor might ask questions about the sex you have to help them decide if you need a test.

When to get an STI test

If you have symptoms of an STI, make an appointment with:  

• your usual doctor
• a medical centre
• Sexual Wellbeing Aotearoa
• a sexual health clinic  

Find a provider

Talk to the provider or organisation where you did your test to find out when they’ll let you know the results.

There is no treatment for hepatitis A. While you’re sick, you will need to rest and stay away from others to avoid passing on the infection. 

• You and your partners or sexual contacts should get the hepatitis A vaccine

• Use condoms or oral dams when you have sex

• Don't have anal sex while you are recovering from hepatitis A   

Talk to the provider or organisation where you did your test to find out when they’ll let you know the results.

Hepatitis B can be treated with medication (tablets). While you’re sick, you will need to rest and protect your liver by avoiding alcohol and some medications and drinking plenty of water.

Most of the time, you can recover from hepatitis B with time and by taking care of yourself. Some severe cases do end up in hospital.  

• If you test positive for hepatitis B, free vaccination is available for the people you live with, and your partners or sexual contacts. 
• Use condoms or oral dams when you have sex 

Talk to the provider or organisation where you did your test to find out when they’ll let you know the results. The person who gave you your diagnosis should refer you for treatment. 

Hep C can now be easily treated with antiviral medications.

If left untreated, it can cause liver disease (cirrhosis), liver failure, and liver cancer. 

• If it's safe, tell people that you have had sexual contact with recently that they might need an STI test or treatment. 
• Anyone that you have shared a needle with might also need an STI test or treatment. 

Vaccination against hepatitis A is recommended before travelling to areas of the world where it is more common. You don’t need a hepatitis A vaccination if you already have the infection. 

To protect yourself and others against hepatitis A: 

• Wash your hands after using the toilet or changing nappies 
• Wash your hands before touching food  
• Use an oral dam when you have mouth on anus sex 

The safe way to protect yourself STIs, including hepatitis B, is using condoms or oral dams every time you have sex.

Hepatitis B is also spread through contact with infected blood. 

Don’t share items which pierce your skin or have blood on them. For example, razors, toothbrushes, or needles used for injectable drugs, or tattoos.

In Aotearoa New Zealand, vaccination against hepatitis B is provided to children for free. This provides lifelong protection from hepatitis B.  

Hep C is spread through contact with infected blood.

Don’t share items which pierce your skin or have blood on them. For example, razors, toothbrushes, or needles used for injectable drugs, acupuncture, or tattoos. 

Hep C may be spread by having unprotected sex.

This includes vaginal sex, anal sex, or oral sex without external or internal condoms or oral dams. 

Condoms and oral dams can protect against hepatitis A, B, and C, and other STIs. 

Using lube with condoms helps to prevent the condom from breaking during sex by reducing friction. Lube can also make sex more pleasurable for some people.

More about safer sex

Many STIs, including hepatitis, don’t have obvious symptoms. You may not know that you have hepatitis but can still pass it on to your partners or sexual contacts. This means it’s important to get tested for STIs regularly.  

If you have sexual contact with multiple people, it’s a good idea to get tested every three months.  

It’s also a good idea to get tested before and after you have sex with a new person – but remember that STIs don’t always show up on tests right away, so wait a couple of weeks before testing.

When to get an STI test