Hepatitis B

At a glance

Vaccine preventable – check who’s eligible
Vaccine included on the National Immunisation Program – check who’s eligible
Nationally notifiable disease

About hepatitis B

Hepatitis B is a viral infection of the liver.

Some people will recover within 6 months as their body clears the virus without treatment.

But most people who get infected will develop chronic hepatitis B, where the infection lasts for more than 6 months.

People infected as babies or young children often develop chronic infection.

After many years, chronic hepatitis B can damage the liver and cause serious disease, including primary liver cancer.

Most people don’t get symptoms until the liver is damaged, so testing people who could have hepatitis B is important.

Why it matters to public health

Hepatitis B is the most common bloodborne virus in Australia. There is no cure, but it is preventable.

More than 220,000 people in Australia live with chronic hepatitis B infection, but 1 in 3 people don’t know they have it.

The spread and impacts of hepatitis B in Australia have been reduced through:

routine vaccination of babies
testing pregnant people and those likely to be exposed to the virus
regular monitoring and long-term treatment for people with chronic infection.

Certain groups continue to be disproportionately impacted by hepatitis B.

Australia is working to eliminate hepatitis B as a public health threat by 2030, by:

monitoring and reporting on hepatitis B in Australia
planning for how to respond to infections and outbreaks
developing and implementing national strategies that guide our work.

Symptoms

If you’re looking for advice about your own health or treatment options, see healthdirect or speak with a qualified healthcare professional. Our role is to provide public health advice – information and guidance that helps prevent disease, protect communities and improve wellbeing at a population level.

Many people with acute hepatitis B infection don’t get symptoms, including:

half of adults
most babies and young children.

For those who get symptoms, they can last for weeks to months and might include:

yellowing of the skin and eyes (jaundice)
dark urine
nausea
vomiting
extreme fatigue
loss of appetite
abdominal pain, especially in the right-hand side
fever.

Most adults recover. But nearly all babies and 1 in 3 young children go on to develop chronic hepatitis B.

After many years, some people with chronic hepatitis B infection develop liver damage and serious complications, including:

About 1 in 4 people with chronic infection die from these complications.

As most people don’t have symptoms until the liver is damaged, infections can go unnoticed for decades. That’s why testing is important.

Read more about the symptoms, diagnosis and treatment of hepatitis B.

healthdirect’s symptom checker can help you decide whether to see a health professional and request testing for hepatitis B.

Check your symptoms

Onset of symptoms

If symptoms of acute hepatitis B appear, they usually start between 1 and 4 months after infection.

How it spreads

The hepatitis B virus is highly infectious and spreads through contact with infected blood and certain other body fluids, such as semen and vaginal fluids.

Spread usually happens:

from a pregnant person to their baby during birth
through unprotected vaginal, oral or anal sex
by sharing injecting drug equipment, including needles and syringes.

It less commonly spreads through:

needlestick injuries
unsterile tattooing, piercing, cosmetic or medical procedures
contact with infected open sores
sharing personal items, such as toothbrushes, razors or nail clippers
receiving unscreened blood transfusions or organ transplants in some overseas countries.

Australia has screened all blood and related products since the early 1990s, so the risk of infection from blood transfusions is extremely low.

Hepatitis B virus is not transmitted through sharing food or casual contact.

Infectious period

People with acute hepatitis B can spread the virus until their body clears the infection.

People with symptoms are usually infectious from several weeks before symptoms begin until about 4 or 5 months later.

People with chronic hepatitis B infection are almost always infectious for their lifetime, even when they don’t have symptoms.

Prevention

Vaccination

Get vaccinated

Vaccination is the best protection against hepatitis B.

Vaccination is recommended for:

all babies
Aboriginal and Torres Strait Islander people
people who are immunocompromised
people with some medical conditions
people in certain occupations
people who travel to areas where hepatitis B is common
certain other people who are at greater risk of exposure.

Babies can get hepatitis B vaccines for free under the National Immunisation Program or state or territory programs. All newborns are eligible to receive their first dose of hepatitis B vaccination shortly after birth, with further doses at 2 months, 4 months and 6 months.

Eligible people aged under 20 years and refugees and other humanitarian entrants of any age can get a free catch-up vaccination. If you are not eligible for a free vaccine, you can buy one from your healthcare professional or pharmacy.

Other prevention steps

In addition to vaccination, the best ways to prevent hepatitis B infection are to:

get tested during pregnancy, especially if you have ever been at greater risk of exposure
never share needles, syringes or other equipment
use condoms and other barrier methods during sex
not share items such as razors, toothbrushes or other personal items
always use sterile equipment for body piercing, tattoos or cosmetic procedures.

If you think you have been in contact with the virus, seek medical help quickly. There are medicines that can lower the risk of infection in certain situations, if given within 3 days.

The best ways to prevent complications from infection are to:

get tested if you might have been exposed to the virus, including regular testing if the exposure is ongoing
if diagnosed with hepatitis B, attend regular check-ups to monitor for liver disease – even before symptoms appear.

Priority groups and settings

Some people are more likely to be infected with hepatitis B or get very sick from it.

People who are at greater risk should take steps to prevent hepatitis B, including vaccination and getting tested – even if they don’t have any symptoms.

Hepatitis B disproportionately affects Aboriginal and Torres Strait Islander people. This is driven by the enduring impacts of colonisation, racism and inequity that have led to higher infection risk and barriers to culturally safe care.

People at greater risk of severe disease

Chronic hepatitis B infection might pose a greater risk of severe illness for:

babies and young children who are infected before the age of 5 years
people with other chronic liver diseases
people with hepatitis C
people who are immunocompromised
people living with HIV.

People at greater risk of exposure

Anyone who is not vaccinated is at risk of infection.

People at greater risk of hepatitis B include those who have:

been born to someone with hepatitis B
been born in an overseas country where hepatitis B is common – almost 3 in 4 people in Australia with chronic infection were infected overseas during early childhood
shared needles, syringes and other injecting drug equipment
had unprotected sex with someone with hepatitis B – especially men who have sex with men
travelled to hepatitis B endemic areas
lived with or had other close contact with someone with hepatitis B
lived a in custodial facility
been a sex worker
received a blood transfusion or organ transplant before 1990 (or more recently in some low- or middle- income countries).

Diagnosis and treatment

Hepatitis B is diagnosed through blood tests.

You can use healthdirect’s directory to find a health service near you.

Find a health service

There is no specific treatment for acute hepatitis B. It is usually treated with supportive care.

People with chronic hepatitis B are monitored for liver damage. Some people might be prescribed medication to help prevent serious liver problems. Search for authorised hepatitis B medicine prescribers near you.

HepLink Australia provides confidential, free and localised viral hepatitis support to callers anywhere in Australia.

Read more about how to manage or treat hepatitis B.

Surveillance and reporting

Hepatitis B is a nationally notifiable disease – these are diseases that present a risk to public health.

Health authorities in each state and territory report laboratory confirmed cases to us daily through the National Notifiable Diseases Surveillance System.

This is part of our surveillance activities, which help us monitor case numbers around the country and understand disease patterns.

We analyse the data and report on case numbers and other data through our data visualisation tool, where you can filter and search the latest information.

Outbreaks

Public health agencies might respond to increases in hepatitis B through:

tailored public health education and messaging about how to prevent hepatitis B
enabling access to appropriate prevention, testing and treatment services
supporting people diagnosed with hepatitis B and their close contacts.

Support

For more information about hepatitis B from community organisations, see:

For information about hepatitis B from your state or territory government, see:

If you need mental health support, see a list of organisations, websites and services that offer support, counselling and information.

For information on staying safe from hepatitis B while travelling, see: