Hepatitis B, also called HBV & Hep B is a serious liver infection caused by the hepatitis B virus that’s easily preventable by a vaccine. This disease is most commonly spread by exposure to infected bodily fluids.
What is it?
- There is no such thing as a 'healthy carrier'
- Infection causes acute, which may progress to chronic, hepatitis
- Transmission occurs from mother to child (vertical) via parenteral exposure (shared injection equipment) or through sexual or household contact (horizontal)
- The risk of developing chronic Hepatitis B is highest if infected at birth or <5 years (>90%). Infection as an adult has a <5% risk of progression to chronic Hepatitis B
- Prevalent among Aboriginal and Torres Strait Islander people living in remote areas and among culturally and linguistically diverse populations
Signs and Symptoms
- Asymptomatic infection: common
- Acute hepatitis: lethargy, nausea, fever, anorexia for a few days then jaundice, pale stools and dark urine, incubation 45-180 days (mean: 60 days)
- Chronic hepatitis: infection lasting over 6 months, can be life-long
A diagnosis of Hepatitis B infection is made using blood tests. Because many people do not have symptoms when they get Hepatitis B they may never be diagnosed. That is why screening for Hepatitis B is recommended in a number of people including:
- People at higher risk
- People who have injected drugs
- Men who have sex with men
- People born in areas of the world where Hepatitis B is widespread
- Aboriginal and Torres Strait Islanders
- People about to have chemotherapy or other treatment that can suppress the immune system
- People with HIV or Hepatitis C
- Pregnant women
In case of acute Hepatitis B infection, treatment is supportive, meaning that it is given with the aim of maintaining comfort, nutrition and fluids but not to cure the disease.
People with chronic Hepatitis B may be treated with medications, including antivirals. These can help reduce the risk of developing liver disease in the long term. People who have chronic Hepatitis B infection are recommended to see their GP or specialist regularly for a check-up as there is a small chance of worsening liver damage and the development of cirrhosis or liver cancer.
Those who already have liver damage should have close medical supervision and may need antiviral medications, regular monitoring and screening for liver cancer. If you have chronic Hepatitis B, you may have to take medicines for the rest of your life.
If you have Hepatitis B and are pregnant, there are treatments available which are effective in preventing your baby from getting Hepatitis B.
- Acute infection should be followed until HBsAg negative
- Chronic infection requires life-long follow-up, including 6-12 monthly Hepatitis B monitoring, yearly Hepatitis BDNA viral load, liver function testing and antiviral therapy if indicated
- Certain populations with chronic Hepatitis B require 6 monthly hepatocellular carcinoma screening (abdominal ultrasound and alphafetoprotein)
- Check Hepatitis A status and vaccinate if susceptible
- Patients with chronic Hepatitis B should be assessed for other causes of Hepatitis (eg. alcohol, fatty liver), and should be counselled to reduce these factors if relevant (eg. reduced alcohol intake)
- Notifiable condition
- Trace back 6 months prior to onset of acute symptoms
- Infectious for 2 weeks before onset of symptoms and until the patient becomes HBsAg (Hepatitis B surface antigen) negative; lifelong if chronic infection
- Test sexual and household contacts and family members, offer vaccination if susceptible, further treatment for those with current infection
- Hepatitis B immunoglobulin (HBIG) given in certain high risk situations, eg. sexual, injecting or occupational exposure or as a birth dose to reduce transmission risk from an HBsAg positive mother to her child
Hepatitis B Vaccine
The hepatitis B vaccine (PDF file, 259.4 KB) is made from parts of the hepatitis B virus. It cannot cause hepatitis B infection. The vaccine is usually given as 3 or 4 shots over a 6-month period. Hepatitis B vaccine is recommended for unvaccinated adults, who are at risk of hepatitis B virus infection, including:
- People whose sex partners have hepatitis B
- Sexually active persons who are not in a long-term monogamous relationship
- Persons seeking evaluation or treatment for a sexually transmitted disease
- Men who have sexual contact with other men
- People who share needles, syringes, or other drug-injection equipment
- People who have household contact with someone injected with the hepatitis B virus
- Health care and public safety workers are at risk of exposure to blood or body fluids
- Residents and staff of facilities for developmentally disabled persons
- Persons in correctional facilities
- Victims of sexual assault or abuse
- Travellers to regions with increased rates of hepatitis B
- People with chronic liver disease, kidney disease, HIV infection, or diabetes
- Anyone who wants to be protected from hepatitis B
There are no known risks to get hepatitis B vaccine at the same time as other vaccines. Please let us know if you have any severe, life-threatening allergies or not feeling well as vaccine should be postponed and reconsidered.
Dosage and Administration
The dose of Hepatitis B vaccine is 1.0mL, to be given by intramuscular injection.
For more information
- Health Direct - Hepatitis B
- Australian STI Management Guidelines - Hepatitis B
- Hepatitis Australia
- Australian Government, Department of Health