Hepatitis B frequently asked questions

What is hepatitis B?

Hepatitis B (also called hep B) is a virus that is found in blood and other body fluids including vaginal fluid, semen and breast milk. It is highly infectious and causes inflammation of the liver. Most adults, but not all, who become infected with hepatitis B are able to clear the virus without any problems. However most babies and young children infected with hepatitis B are unable to clear the virus and will develop a chronic hepatitis infection.

Hepatitis B is one of the most common infectious diseases in the world and is a serious public health concern. Hepatitis B is a vaccine preventable illness.

Who is at risk of getting hepatitis B?

There are around 165 000 people living with hepatitis B in Australia. The majority belong to one or more of the following groups:

  • people who have migrated from countries where hepatitis B is endemic (especially North-East and South-East Asia, and sub-Saharan Africa)
  • Aboriginal and Torres Strait Islander people
  • people who inject drugs
  • men who have sex with men.

How do you get hepatitis B?

Hepatitis B is most commonly spread by:

  • at birth (from mother to child) or in early childhood (from family members or other close contacts)
  • through sharing drug injecting equipment
  • through vaginal, anal or oral sex without a condom/dental dam
  • through unsterile tattooing or piercing.

There is also a chance that it can be spread through:

  • blood-to-blood contact through open wounds
  • needle stick injuries
  • sharing personal items such as toothbrushes, razor blades or nail clippers
  • blood transfusions/products (especially rare in Australia)*
  • unsterilised medical equipment (especially rare in Australia)* (screening for hepatitis B in blood supply has been in place in Australia since 1971).

You cannot get hepatitis B from:

  • hugging, kissing, another person’s tears or sneezes
  • sharing cups, plates, clothes, food, drinks, showers or toilets
  • eating food prepared by a person with hepatitis B
  • mosquito bites.

What are the symptoms for hepatitis B?

Symptoms can take up to 6 months to appear, and are likely to make you sick for between 1 and 3 months. If you do get symptoms, these are the most common:

  • yellow skin or eyes (jaundice)
  • feeling tired
  • losing your appetite and weight loss
  • aches and pains in muscles and joint
  • dark urine and pale faeces.

What is acute hepatitis B?

If someone has hepatitis B for less than 6 months it is called an acute infection. Most people who get hepatitis B as adults will only have an acute infection and recover from it. If you have acute hepatitis B, you might not experience any symptoms.

The older a person is when they become infected with hepatitis B, the better their chances of successfully fighting it off (‘clearing’ the virus). Around 95% of adults who contract hepatitis B will go on to have an acute infection and are then clear it naturally. On the other hand, up to 90% of babies and 30% of children who become infected will go on to have chronic hepatitis B.

What is chronic hepatitis B?

If the infection lasts for longer than 6 months it is called chronic hepatitis B. Most people with chronic hepatitis B contracted it as babies or young children. Many people with chronic hepatitis B have no symptoms, but if they appear they are similar to the symptoms of acute hepatitis B. Chronic hepatitis B is a lifelong illness.

What happens to people with chronic hepatitis B?

Chronic hepatitis B it is a lifelong illness. Each person’s experience of the illness will be different, and will depend on a number of factors like what stage his or her hepatitis B is currently in, lifestyle factors, and how long he or she has the virus.

However we do know that 20 to 30% of people with chronic hepatitis B will develop advanced liver disease if the virus is left untreated. Advanced liver disease can lead to complications including liver failure and liver cancer, and unfortunately, can lead to death. Treatment for hepatitis B aims to avoid these outcomes.

How is hepatitis B treated?

Treatment aims to stop or slow as much as possible, the increase in numbers of hepatitis B viruses. This decreases the risk of serious liver disease developing later in life and makes it possible for the liver to repair some of the damage and to work better.

Can a person spread hepatitis B and not know it?

Yes. Many people with acute hepatitis B have no symptoms and may not even know they have hepatitis B.

How long does the hepatitis B virus survive outside the body?

Hepatitis B virus can survive outside the body for at least 7 days. During that time, the virus can still cause infection if it enters the body of a person who is not infected.

What if I am exposed to hepatitis B, what should I do?

You should see your GP or local health centre as soon as possible to discuss your options.  You will need to have a blood test and in some cases you may start treatment immediately to stop your body becoming infected with Hepatitis B. Management may include hepatitis B immunoglobulin, an injection of plasma which contains high levels of antibodies to help prevent hepatitis B infection from developing in a person who has been exposed.

If I’ve had hepatitis B and cleared it, can I get it again?

If your body has naturally cleared the hepatitis B virus, then you will be immune. This means you cannot get hepatitis B again.

What tests are there for hepatitis B?

All of the tests used to diagnose hepatitis B are blood tests. Some indicate different stages of the illness or immunity. The following list shows the different tests available, and what a positive result indicates for each of them.

  • Hepatitis B surface antigen (HBsAg) - Shows the person has hepatitis B.  It can be detected during acute and chronic infection.
  • Hepatitis B surface antibody (HBsAb or anti-HBs) - Shows the person has developed immunity to hepatitis B. It can be detected in people who have recovered from acute hepatitis B or been vaccinated against it.
  • Hepatitis B e antigen (HBeAg) - Shows the hepatitis B virus is multiplying, and that it can be more easily passed on.
  • Hepatitis B e antibody (HBeAb or Anti-HBe) - Shows the person’s immune system has responded to hepatitis B and in some circumstances, the virus is not actively replicating.
  • Hepatitis B core antibody (HBcAb or Anti-HBc) - Shows a person has had hepatitis B, either past or present infection. If someone has immunity through vaccination he or she will not test positive.
  • Hepatitis B virus DNA (HBV DNA) - Measures the amount of hepatitis B virus in the bloodstream and indicates how actively the virus is multiplying.

How can I protect myself until I am full vaccinated?

  • practice safer sex (use a condom)
  • wash hands after touching blood or body fluids
  • wear disposable gloves if giving someone first aid, or cleaning up blood or body fluids
  • avoid sharing toothbrushes, razors, needles, syringes, personal hygiene items and grooming aids or any object that may come into contact with blood or body fluids
  • use new and sterile injecting equipment for each injection
  • cover all cuts and open sores with a waterproof dressing
  • wipe up any blood spills and then clean the area with household
  • throw away personal items such as tissues, menstrual pads, tampons and bandages in a sealed plastic bag.