Hepatitis B
Hepatitis B is a viral infection of the liver caused by the hepatitis B virus. Hepatitis means inflammation of the liver. There are other viruses that cause inflammation of the liver such as hepatitis A, C, D and E.
Symptoms
Most people with hepatitis B have no symptoms at all when they are first infected with hepatitis B.
If there are symptoms, they usually develop within six weeks to six months of exposure to the virus and can include:
- flu-like symptoms
- loss of appetite
- nausea
- vomiting
- tiredness
- abdominal stomach pain
- loss of appetite
- yellowing of the skin and eyes (jaundice)
- dark urine
- pale stools
- sometimes fever, rash and joint pain.
These symptoms usually only last a few weeks.
Infection length
Most people who acquire hepatitis B as adults, will clear the infection naturally within six months. These people will develop life-long immunity and will no longer be infectious. Those who do not clear the infection will go on to have a chronic or long-term hepatitis B infection.
Chronic hepatitis B may cause inflammation of the liver with no symptoms at all. Over time, without regular medical/specialist follow up, this inflammation may cause permanent liver damage or liver cancer.
People who acquire hepatitis B as babies and those with immune disorders are more likely to develop a chronic infection and are at an increased risk of developing advanced liver disease.
Diagnosis
The hepatitis B virus can be detected by a blood test which is available from your doctor. Pregnant women are routinely tested as part of antenatal care.
How hepatitis B is spread
Hepatitis B virus is found in the blood and body fluids of people with the virus, including semen and vaginal fluids.
The virus can be passed on by:
- a mother with hepatitis B to her baby during pregnancy or at the time of the baby’s birth
- unprotected vaginal or anal sex (not wearing a condom)
- contact with infected blood, such as:
- sharing injecting drug equipment
- non-sterile or shared equipment used in tattooing, body piercing and acupuncture
- shared personal items such as toothbrushes and razors
- accidental needle-stick injury or blood splash e.g. in a health care setting
- direct contact between infective body fluids and open sores or wounds.
Hepatitis B cannot be transmitted by saliva, tears or breast milk. It is also not transmitted by contaminated food or water.
Who is at risk of infection
Anyone who is not immune to hepatitis B can be infected with the virus. Those most at risk of infection include:
- people who inject drugs
- men who have sex with men
- people born in countries with a high prevalence of hepatitis B and their children
- babies born to mothers with hepatitis B
- people who don’t wear condoms with new or casual sexual partners
- Aboriginal and Torres Strait Islander people
- inmates at correctional facilities.
The risk of acquiring hepatitis B through blood transfusions in Australia is extremely low due to screening of all blood donors by Australian blood banks.
Prevention
Hepatitis B can be prevented by:
- vaccination
- treating babies of mothers with hepatitis B at birth with immunoglobulin and vaccine
- never sharing injecting drug equipment
- wearing gloves and protective clothing when handling other people’s blood or body fluids
- always using condoms with new or casual sexual partners
- not sharing personal items such as razors and toothbrushes, which can transfer blood
- having any tattooing/body art performed only at licensed premises
- seeking medical advice as soon as possible after a needle stick injury or after possible sexual exposure.
Vaccination
Hepatitis B vaccination is part of the funded National Immunisation Program (NIP) and is offered to all babies at birth, two, four and six months of age. Catch-up vaccination is also funded for persons under 20 years of age.
The following people can also access free hepatitis B vaccine through their doctor:
- sexual and/or household contacts of a person with hepatitis B
- people who inject drugs;
- refugees and humanitarian entrants into Australia who have no history of hepatitis B immunisation.
Hepatitis B vaccination is also recommended (but not usually funded) for:
- those with multiple sexual partners
- people with certain chronic medical conditions and impaired immunity e.g. HIV, haemodialysis patients
- people with chronic liver disease and/or hepatitis C
- individuals with occupational risks e.g. health care workers, embalmers, tattooists and body-piercing workers, acupuncturists, sex industry workers
- residents and staff of facilities for persons with intellectual disabilities
- inmates and staff of long-term correctional facilities
- travellers to regions where hepatitis B is common
- migrants from countries where hepatitis B is common
- Aboriginal and Torres Strait Islander people.
Treatment
While there is no cure, there are treatments that can help manage chronic hepatitis B. Some people may be prescribed anti-viral medication that can reduce the risk of developing serious liver disease.
If you have been diagnosed with hepatitis B you should:
- have a liver health assessment and discuss treatment options with your doctor
- have regular medical/specialist follow up appointments
- advise regular sexual partners and household contacts to discuss testing and vaccination with their doctor
- limit or avoid alcohol and maintain a healthy lifestyle
- consider getting vaccinated against hepatitis A to minimise damage to the liver
- contact Hepatitis ACT for further information and support on 1300 301 383 or go to HepatitisACT.
More information
For more information about hepatitis B contact either:
- your doctor
- HepatitisACT
- the Health Protection Service, Communicable Disease Control Information Line during business hours on 02 5124 9213.
Hepatitis B is a notifiable disease.
Acknowledgements
- Heymann DL. Control of Communicable Diseases Manual. 20th edn. Washington: American Public Health Association, USA; 2015.
- Australian Technical Advisory Group on Immunisation (ATAGI). Australian Immunisation Handbook, Australian Government Department of Health, Canberra, 2018.