Hepatitis B

Key points

  • Hepatitis B is an infection of the liver caused by a virus
  • Adults usually catch the hepatitis B virus from body fluids like blood or semen (not saliva)
  • You might only be sick for a short time, but some people carry the virus for a long time
  • Some people catch the hepatitis B virus when they are born and have it all their life
  • Hepatitis B can seriously damage your liver over time
  • Hepatitis B is a silent disease because there may be no symptoms
  • There is treatment for hepatitis B that is given to keep you healthy. But there is no cure
  • If you have long-term (chronic) hepatitis B, it’s important to see your doctor regularly to see if you need treatment as things can change over time
  • There is a very good vaccine for hepatitis B
  • If you’re at risk, it’s best to get vaccinated to protect against hepatitis B

What is hepatitis B?

Hepatitis B is an infection of the liver caused by a virus. The hepatitis B virus is sometimes called hep B or HBV.

You might have caught hepatitis B virus when you were born and may have had it all your life. This happens when your mother had long-term (chronic) hepatitis B when you were born.

Adults usually catch the hepatitis B virus from body fluids like blood or semen (not saliva) such as through using injecting drugs or through sex.

There are 2 types of hepatitis B.

Acute hepatitis B: You might feel sick for a short time and then get better. Most adults (95 in 100) clear the virus out of their body with no treatment.

Chronic hepatitis B: The virus stays in your body for more than 6 months. You might not feel sick, but the virus can do serious damage to your liver over time, leading to:

Babies and children who are infected with hepatitis B are much more likely to develop chronic hepatitis B than adults.

Chronic hepatitis B is a ‘silent’ disease, meaning you might not have symptoms until your liver is severely damaged.

In Australia, more than 220,000 people have chronic hepatitis B. It’s the most common liver virus in the world.


How do you catch hepatitis B?

Most people in the world with chronic hepatitis B caught it when they were very young. Babies can catch it from their mother during childbirth. Most people in Australia with chronic hepatitis B were born overseas in countries with high rates of hepatitis B in the population.

All pregnant women are routinely tested for hepatitis B in early pregnancy. If you are diagnosed with hepatitis B when you are pregnant, you might have had it your whole life.

If you have hepatitis B and you are pregnant, your baby will need 2 injections in the first 12 hours after birth to protect them. If you have a high level of hepatitis B virus in the blood you will also be recommended to take an antiviral medicine from 28 weeks of pregnancy to give extra protection to your baby.

 

Unvaccinated adults can catch hepatitis B from:

  • vaginal, anal or oral sex without a condom
  • tattooing, body piercing, manicure/pedicures, or having a medical procedure using unsterile equipment
  • sharing equipment for injecting drugs
  • sharing toothbrushes or razors
  • giving first aid to someone who is infected

You can’t get hepatitis B from kissing, hugging, sharing food, sneezing or coughing.

Vaccination is highly effective in protecting against infection.


What are the symptoms of hepatitis B?

In children, hepatitis B usually doesn’t cause any symptoms. They might have the virus their whole life and not realise until they develop liver disease when they are older.

In adults, hepatitis B might cause a short illness with symptoms including:

  • yellow eyes or skin (jaundice)
  • dark urine
  • pale poos
  • feeling very tired
  • swollen and sore belly, especially on the upper right side (where the liver is)
  • not feeling hungry
  • muscle and joint pain

You might have chronic hepatitis B and not realise it. If your liver is damaged, you might notice symptoms such as:

  • bleeding and bruising easily
  • feeling very tired
  • not feeling hungry
  • yellow skin and eyes (jaundice)
  • dark wee
  • itchy skin
  • fluid in the belly
  • swollen legs
  • weight loss
  • confusion
  • spider veins
Read more about the symptoms of liver disease

How is hepatitis B diagnosed?

Hepatitis B is diagnosed with a blood test that looks for the virus. You need to ask your doctor for the test, as it is not routine.

The blood test looks for whether you have the virus in your blood now, whether you have ever had the virus, and whether you are immune to the virus.

If you do have the virus, you will have more tests to see how much damage has been done to your liver. Your family and people you live with should also get tested.

If you test negative, you can talk to your doctor about being vaccinated.

Read more about liver tests

Should I be tested for hepatitis B?

It’s recommended these people are tested for hepatitis B:

  • People with chronic liver diseases
  • People living with chronic hepatitis C
  • People who are at risk of serious liver disease
  • Children born to mothers with hepatitis B
  • Household and sexual contacts of people with hepatitis B
  • People who inject drugs
  • Men who have sex with men
  • People with multiple sexual partners
  • Aboriginal and Torres Strait Islander people
  • People who have ever been in prison
  • People born overseas in places where hepatitis B is common
  • People who are at risk of giving it to someone else
  • Pregnant women
  • People who are getting immunosuppressive therapy
  • Healthcare workers
  • People on kidney dialysis
  • People living with HIV
If you have chronic hepatitis B, or had hepatitis B in the past, anything that weakens your immune system can bring back the virus. This can lead to serious liver damage. You should be tested for hepatitis B before taking medicines that suppress your immune system, like high-dose corticosteroids, chemotherapy or treatments for autoimmune conditions.

How can I prevent hepatitis B?

Hepatitis B is very common, especially in some countries in Asia, Pacific Islands, Africa and Europe. Indigenous Australians have higher rates of hepatitis B infection than non-Indigenous people who were born in Australia.

You can avoid catching the virus by being vaccinated. You need 3 doses of the vaccine over 6 months.

The vaccine is free in Australia for babies at 2, 4 and 6 months. It’s also recommended for:

  • all Aboriginal and Torres Strait Islander people
  • people whose immune system doesn’t work properly, including before you have a transplant
  • people with certain medical conditions
  • people whose jobs put them at higher risk
  • people travelling to areas where hepatitis B is common
  • people who are at risk of coming into contact with an infected person
If you any sort of liver disease, including another form of hepatitis, it’s recommended you have the hepatitis B vaccine to protect your liver.

 

If you are unvaccinated, you can avoid catching the virus by:

  • having safe sex (using a condom)
  • not sharing needles to inject drugs
  • making sure tattoo or piercing equipment is sterilised
  • covering any wounds
  • not sharing razors or toothbrushes
  • using gloves when giving first aid
If you think you have been exposed to hepatitis B, see your doctor straight away. An injection of an antibody called immunoglobulin can stop you getting sick.

 


How is hepatitis B treated?

Most people with acute hepatitis B do not need treatment. The best thing is to rest, drink plenty of fluids, eat well and avoid alcohol.

Some people with chronic hepatitis B should be treated with antiviral medicine. This is a tablet taken once a day, usually for life. Your doctor will decide whether you need to have treatment.

This medicine doesn’t get rid of the virus, but it can control it and protect your liver. It’s important not to stop taking the medicine unless your doctor tells you it is OK to do so, as your liver can become severely damaged very quickly, putting your life at risk.

Even if you are not prescribed medicine, it is important that you have a check-up at least once a year because chronic hepatitis B can change over time and you might need treatment in the future.

Read more about liver treatments

Living with hepatitis B

Anyone with any form of liver disease should protect their liver by:

  • being a healthy weight
  • eating a balanced diet and limiting intake of high sugar-containing and ultraprocessed foods
  • doing more physical activity
  • managing high blood pressure and cholesterol
  • reducing further harm to your liver from alcohol

But hepatitis B can’t be controlled just by lifestyle. Many people will also need medicine. It’s important to follow the advice of your doctor to avoid serious liver problems in future.


Additional information and support


What next?

Read more about living well

References

American Liver Foundation. Hepatitis B

Australian Department of Health & Aged Care. Hepatitis B vaccine

Australian Department of Health & Aged Care. Hepatitis B

Australian Immunisation Handbook. Hepatitis B

Canadian Liver Foundation. Hepatitis B

GESA. Hepatitis B Virus (HBV) Consensus Statement

Hepatitis Australia. What is hepatitis B? 

Mayo Clinic. Hepatitis B

Reviewed November 2022

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