My husband has hepatitis B antibodies, and I have already gotten my vaccination. Is it save for us to have sex and also to start a family?

H.

The hepatitis B virus is a common cause of viral hepatitis (liver infection). The infection may not cause any symptoms at all, or the person may develop fever, right-side abdominal pain, and jaundice (yellowing of the skin and eyes). This disease, called acute hepatitis, ranges from a mild syndrome that goes away without treatment, to a severe, fatal illness. There is no specific treatment, but in the rare cases of severe disease, a liver transplant may be performed.

More than 90 percent of the time, the patient recovers and the virus is eliminated from the body. In fewer than 10 percent of cases, patients develop chronic infection. Chronic disease can take many forms. Some patients are just "chronic carriers" who always have the hepatitis B virus and can pass it on to others but have no active liver disease. At the other extreme are patients with "chronic active hepatitis," which causes severe liver disease, resulting in cirrhosis (liver scarring) and death. Liver cancer can also result from chronic infection with hepatitis B.

You say your husband has hepatitis B antibodies. I am not sure exactly what you mean by this statement. There are many different types of disease-fighting antibodies to hepatitis B. One of these, the hepatitis B "surface antibody," indicates that the patient has had hepatitis B infection in the past (or has been vaccinated against it) and has eliminated the virus and is now immune. If your husband has "surface antibody," then he poses no risk to you at all. Other hepatitis B antibodies, such as "core antibody" and "e antibody," do not necessarily indicate that the patient is immune.

A positive result on another hepatitis B test, called the "surface antigen" test, would indicate that your husband has a chronic infection and can pass the virus to others. If that is the case, then you should avoid intercourse with him until you have completed your vaccine regimen. In addition, you should have a blood test confirming that the vaccine has successfully immunized you before you resume unprotected sexual relations. Once you have the surface antibody yourself, reflecting successful immunization, then his infection should pose no risk to you or to your future children.