World Hepatitis Day 2020: Understanding Hepatitis B and Male Fertility Dr. Sneha Sathe, Fertility Consultant, Nova IVF Fertility Mumbai.


Hepatitis B is a major global health problem It is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). Hepatitis B infection may be either acute (short-lived) or chronic (long-lasting). The acute infection lasts less than six months. Most people who get hepatitis B as adults have an acute infection. An acute infection can sometimes lead to chronic infection. Chronic hepatitis B infection lasts six months or longer. It lingers because the immune system can’t fight off the infection completely. Chronic infection can last a lifetime, and lead to serious illnesses such as cirrhosis and liver cancer. The risk of hepatitis B becoming chronic is much higher if the infection happens in childhood.

Worldwide, more than 250 million people are chronically infected (defined as hepatitis B surface antigen-positive). There is very poor awareness regarding hepatitis B infection among the general public. According to the WHO, as of 2016, 27 million people (10.5% of all people estimated to be living with hepatitis B) were aware of their infection, while 4.5 million (16.7%) of the people diagnosed were on treatment.

Hepatitis B spreads through contact with blood, semen or other body fluids from an infected person. If a woman has hepatitis B infection, depending on her infectivity status, there is a risk of transmission of the infection to the baby during pregnancy, during delivery (most common) or with breastfeeding.

Chronic hepatitis B infection in men can lead to infertility. Hepatitis B DNA can integrate into the spermatozoa itself and HBV-infected men are shown to have lower semen volume, lower total sperm count as well as poor sperm motility and morphology. In couples where only the male partner is infected with chronic hepatitis B, vaccination of the female partner has been shown to eliminate the risk of transmission to her and thus of perinatal transmission to the child.

Screening for viral illnesses like Hepatitis B, Hepatitis C and HIV should be routinely offered to infertile couples prior to initiating treatment. If either partner is found to be Hepatitis B positive, further testing to know the infectivity status (in collaboration with a gastroenterologist), vaccination of non-infected partner and counselling from a fertility expert to decide the further course of action is advisable. `