Is it safe to marry someone with hepatitis B?

Question

Hello doctor,

Can I marry a man who has been diagnosed with hepatitis B?

My nurse friend and another doctor think it is unwise because I have never been sexually active and may be putting myself and any future children at risk.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

This is a deeply personal decision, and it is good that you are gathering information. The medical evidence actually says the risk is manageable with proper precautions.

Hepatitis B is transmitted through blood, sexual contact, and from mother to child during birth, but there are very effective ways to protect yourself and your future children.

There are several protective steps that can help you prevent this infection. The protective steps are:

The hepatitis B vaccine is highly effective (about 95 percent) at preventing infection. If you have not been vaccinated, you can complete the three-dose series before becoming sexually active with him.
After vaccination, you can get a blood test to confirm that you have developed immunity (called anti-HBs or anti-hepatitis B antibody testing).
Once immunity is confirmed, your personal risk drops dramatically.

You should adopt several steps by which you can protect your children.

Transmission from an infected father to a child during pregnancy is not a direct risk because the father does not carry the baby.
If you remain uninfected, which vaccination helps ensure, there is no mother-to-child transmission risk from you.
All newborns in most countries already receive the hepatitis B vaccine at birth, which is standard practice regardless of parental status.

His viral load matters. People with low or undetectable viral loads, especially when managed with antiviral medication such as Tenofovir, are far less infectious. He should be under the care of a hepatologist or infectious disease specialist and ideally on treatment if his viral load is high.

Your nurse friend and doctor are right to point out the risk, but the risk is not unmanageable. Many couples worldwide live in this exact situation (discordant couples) and have healthy marriages and healthy children.

Please follow the underlying steps. The key steps are:

Get vaccinated.
Confirm immunity with anti-HBs testing.
Ensure he is receiving appropriate medical management.

I hope I have answered your question.

Thank you.