Hepatitis B

Hepatitis is a general term used to describe inflammation of the liver. Viruses are the most common cause of hepatitis but there are many other causes including alcohol and medication.

The hepatitis B virus causes hepatitis B infection and mainly affects the liver.

How does someone become infected

An infected person can transmit the hepatitis B virus to another person by blood, blood products, semen, vaginal fluids and saliva. This can occur by direct injection or through breaks in the skin or via mucous membrane contact.

The virus can be spread:

  • by sharing injecting equipment
  • by vaginal, anal or oral sex without a condom
  • from mother to baby at the time of birth or during pregnancy
  • by contact between open sores or wounds
  • by exposure to blood via shared tattooing equipment, acupuncture needles, nail clippers, razors and toothbrushes
  • by accidental needle stick injury
  • by blood transfusion (very rare in Australia).

Symptoms

The symptoms generally develop 2 to 3 months after infection, but may develop from 6 weeks to 6 months after infection.

The symptoms may include mild fever, tiredness, lack of appetite, nausea, vomiting, abdominal pain, muscle and joint pain, additional signs of hepatitis include rash, dark urine and pale faeces, yellowing of the eyes and skin (jaundice). Jaundice may be difficult to see in dark skinned people.

The symptoms and signs are generally more severe in adults than children. Many children will have no symptoms or mild symptoms only.

Acute and chronic infection

Most (95%) adults who become infected with hepatitis B will usually clear the infection within 6 months. These people become immune and cannot catch the virus again.

A small percentage of adults will continue to have hepatitis infection for more than 6 months after the initial acute infection (chronic infection).

Almost all babies and young children infected with hepatitis B will develop chronic infection.

People who develop chronic hepatitis B will usually have no symptoms for many years, however without proper treatment a large number of infected people will eventually develop life threatening liver failure or liver cancer. People with chronic hepatitis B need regular follow-up by a clinic and referral for treatment if indicated.

Infectious period

People with acute hepatitis infection can transmit the infection to others from several weeks before they become ill and for the next 6 months. 

People who go on to have chronic infection will continue to be infectious to others unless they are taking effective treatment or their body clears the infection.

Prevention

Hepatitis B can be prevented by:

  • vaccination (vaccination of all infants at birth is now recommended)
  • administering hepatitis B immunoglobulin at birth to all babies of mothers who have chronic hepatitis B and giving medication to pregnant women at especially high risk of passing on the virus
  • never sharing injecting drug equipment
  • wearing protective gloves, clothing and face shield when handling blood or body fluids
  • practicing safer sex
  • not sharing personal items such as razors and toothbrushes
  • having any tattooing/body piercing performed by a registered tattooist/beautician.

Hepatitis B vaccination

There are several types of hepatitis B vaccine available in Australia including combination vaccines. Since 1990 all children have been offered the vaccine at birth, 2, 4 and 6 months of age as part of the National Immunisation Program.

Vaccination is recommended for non-vaccinated people who are:

  • household and sexual contacts of a person with hepatitis B
  • injecting drug users
  • haemodialysis and renal transplant patients
  • regular recipients of blood products
  • hepatitis C antibody positive and/or have chronic liver disease
  • HIV positive or are immunocompromised
  • men who have sex with men
  • migrants from countries where hepatitis b is prevalent
  • sex industry workers
  • residents and staff of facilities for persons with intellectual disabilities
  • inmates and staff of long term correctional facilities
  • health care workers and embalmers.

Hepatitis B vaccine for adults is usually self or employer funded. Pre and post vaccination blood tests are only recommended for certain groups. 

Booster doses are generally not recommended. Talk to your General Practitioner (GP) or health provider.

What happens to those exposed to hepatitis B

When an individual is exposed to the hepatitis B virus (eg via accidental needle stick injury or a sexual partner found to have hepatitis B) a blood test to determine that exposed individual’s immune status should be taken.

Based on the results of the blood test the person may be offered immunoglobulin and/or vaccination.  Both vaccination and immunoglobulin may prevent infection if given within 72 hours of exposure to the virus.

People with hepatitis B do not need to be excluded from work, school or sport. Health care workers performing ‘exposure prone procedures’ should seek specialist advice.

People with chronic hepatitis B infection will require ongoing follow-up with their GP and a liver clinic specialist.

Treatment

People with acute hepatitis B usually do not require specific treatment.

People with chronic hepatitis B (surface antigen positive) require regular monitoring for complications and in many cases lifelong antiviral medication. Treatment will generally prevent damage to the liver and reduce the chance of infecting other people.

Contact

For more information contact the Centre for Disease Control's Clinic 34.

Last updated: 27 June 2017