Hepatitis B

Hepatitis B is a virus that affects the liver. It is transmitted through sex and through blood-to-blood contact. It is prevented through vaccination, safe sex, and safe injecting. People at higher risk should be vaccinated.

Last updated: 26 June 2008

What is Hepatitis B?

Hepatitis is a disease that causes inflammation or swelling of the liver. Hepatitis B is one of the viruses that cause this condition. The other hepatitis viruses are also named with a letter, for example: hepatitis A, hepatitis B and hepatitis C.

In Australia, up to 400 cases of hepatitis B are detected each year with about 1 person in every 100 having evidence of past exposure to the virus.

What are the symptoms?

Many people who contract hepatitis B don't notice any symptoms or may have only mild symptoms that clear in a few weeks.

When symptoms are noticed, they usually develop within three months and can include a mild flu-like illness, nausea, dark urine, vomiting, loss of appetite, fatigue, general aches and pains, and yellowing of the skin and eyes (jaundice).

Most adults who have hepatitis B recover or 'clear' the infection. They develop lifelong immunity and are no longer infectious.

About 5% to 10% of people remain infectious for many years. This is known as chronic hepatitis B infection. Even though they may look and feel well, people with chronic hepatitis B carry the infection and can transmit it to others. Chronic hepatitis B infection slowly damages the liver so a small number of people with this condition may suffer liver failure or cancer of the liver.

How is it spread?

The hepatitis B virus is spread when body fluids (blood, semen, saliva or vaginal fluid) from an infected person enter the blood stream of another person. This can occur in different ways:
• vaginal, anal or oral sex without a condom
• any form of skin penetration with non-sterile equipment, including: sharing needles, syringes and other injecting drug equipment; needle stick injuries; tattooing; acupuncture and body piercing
• sharing toothbrushes, razors, sex toys or other items that may have blood on them
• mother to child transmission during pregnancy or childbirth
• when blood from an infected person makes direct contact with an open wound or cut of a person who is not infected

Who is at risk?

The people who are most at risk of catching Hepatitis B are unvaccinated people who:
• share injecting equipment
• the children of infected mothers
• have sex within high prevalence populations, such as travellers, and men who have sex with men
• who practice unsafe sex with new or casual partners
• health care workers, sex workers, people who play contact sports, tattooists and body piercers, acupuncturists

How is it prevented?

The best way to prevent the spread of hepatitis B is to get vaccinated. Hepatitis B vaccination is available for everyone, including children, through your local doctor. It is also available at sexual health clinics for some people at higher risk of infection. The vaccination consists of 3 injections over 6 months. It is safe and reliable.

To reduce the risk of transmission among unvaccinated people:
• don't share injecting equipment
• use condoms for anal and vaginal sex
• avoid oral sex where blood is present (menstruation, gum disease, herpes, cold-sores, cuts)
• don't share razors, toothbrushes, sex toys and other personal items
• use gloves to dress wounds and clean spills of blood and other body fluids

If you have been exposed to hepatitis B, see your doctor immediately. An injection of a drug called immunoglobulin can be given after hepatitis B exposure that may prevent the infection taking hold. The drug must be taken within 72 hours of a needle stick injury or shared injecting incident, and within 14 days after a possible sexual exposure.

How is it diagnosed?

Hepatitis B is detected by a blood test. Blood tests can show if a person has a recent infection, has a chronic infection or has had hepatitis B in the past but is no longer infectious. Blood tests can also be done to check for damage to the liver.

How is it treated?

There is no cure for hepatitis B, which is why vaccination is very important. People in the initial stages of infection need to rest, drink plenty of fluids and avoid alcohol and other drugs. Recovery can take some months.

Immunoglobulin injections may help prevent infection if given soon after exposure (see above). There are treatments available to manage chronic hepatitis B. Your doctor may refer you to a specialist to discuss treatment.

What advice should be given to people who are carriers of hepatitis B?

• Always use condoms with new sex partners.
• Advise regular sexual partners to be vaccinated for hepatitis B and use condoms until the vaccination course has been completed.
• Do not donate blood, semen or organs.
• Do not share razors or toothbrushes.
• Do not share needles or syringes.
• Look after your health by having a well-balanced diet. Avoid fatty foods if they cause discomfort. Exercise regularly, reduce/avoid alcohol and reduce/stop smoking.
• Make sure you have regular follow-up appointments with your doctor.
• If you see another doctor who might prescribe some medicine, you should mention that you carry hepatitis B because many drugs either affect the liver or are excreted by it.

What is the public health response?

Hepatitis B can be infectious for 6 months before the symptoms are noticeable. If you have been diagnosed with hepatitis B it is important to tell anyone you may have infected so they can also be treated with immunoglobulin and so they do not infect others. Your doctor or sexual health clinic can help you decide who may be at risk and help you to contact them. If you wish, this can be done anonymously by your doctor.
Hepatitis B is a notifiable disease. This means that doctors and laboratory staff are legally required to tell the Department of Public Health about new cases. These notifications are used to help find and treat others who may be at risk before they become ill or infect others. The data is also used for public health planning.

Further Information

Sexual Health Information Line (02) 9382 7440 or Freecall 1800 451 624 (outside Sydney).

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