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Hepatitis B infection

Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. ‘Hepatitis’ is an inflammation of the liver. It has many causes, including viral infection. 

Vaccination is safe and effective in protecting against hepatitis B.
Vaccination is safe and effective in protecting against hepatitis B.
Viral hepatitis can be caused by hepatitis A, B, C, D and E viruses. It can also be caused by glandular fever (EBV) and cytomegalovirus (CMV).
 
In hepatitis B, the virus infects the liver cells and causes an immune response which can lead to liver damage over time.
 

How do I get hepatitis B?

Most people with hepatitis B become infected at the time of their birth or in early childhood. This is usually the case in places where hepatitis B is widespread.
 

If you have hepatitis B it's important to protect others from infection.

 
Some people get hepatitis B when they are older. It can happen through exposure to infected blood and other bodily fluids in the following situations:
 
  • sharing needles and other injecting drug equipment
  • sexual contact (either heterosexual or homosexual)
  • tattooing with unsterilised needles and equipment
  • close family contact with someone with hepatitis B 
  • accidental exposure such as a needle stick injury or being splashed with infected blood or body fluid
  • blood transfusion – this is now very rare as blood in Australia is screened for hepatitis B.

What are the signs and symptoms of hepatitis B?

Many people don’t have any symptoms when they are first infected with hepatitis B. People that do have symptoms or signs may get:
 

How do I know I have hepatitis B?

A diagnosis of hepatitis B infection is made using a number of blood tests.
 
Because many people do not have symptoms when they get hepatitis B they may never be diagnosed. That’s why screening for hepatitis B is recommended in a number of people including:
 
  • people at higher risk, eg:
    • Aboriginal and Torres Strait Islanders
    • people who have injected drugs
    • men who have sex with men
    • people born in areas of the world where hepatitis B is widespread
  • people about to have chemotherapy or other treatment that can suppress the immune system
  • people with HIV or hepatitis C
  • pregnant women.
If you think you have been exposed to infected blood or body fluids, see a doctor as soon as possible. There are treatments which can reduce your risk of developing the infection, if given shortly after exposure.
 

What are the long term effects of hepatitis B?

The course of hepatitis B infection depends mostly on the age at which a person is infected.
 
People infected at birth or in early childhood are likely to develop long term (chronic) infection and can get complications such as scarring of the liver (cirrhosis) or liver cancer.
 
People infected as teenagers and adults have a 50% chance of becoming unwell with symptoms (acute hepatitis). The other 50% develop a silent infection, without any symptoms.
 
Most people infected as adults (approximately 95%) clear the virus from the body within 6 months. They develop immunity to future hepatitis B infections and do not develop long-term liver damage.
 
However, approximately 5% of adults can’t clear the virus and develop chronic hepatitis B. They are at risk of developing complications such as cirrhosis and liver cancer in the longer term. About 218,000 Australians are currently living with hepatitis B. 
 

What is the treatment for hepatitis B?

The treatment for acute infection is supportive, aiming to maintain comfort, nutrition and fluids.
 
People with chronic hepatitis B may be treated with antiviral medications. 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 doctor or specialist regularly for a check-up. 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.
 

What if I am pregnant?

It's recommended that all pregnant women be screened for hepatitis B in early pregnancy.
 
If you have hepatitis B and are pregnant, there are treatments available which are effective in preventing your baby from getting hepatitis B.
 

How do I prevent infection with hepatitis B?

If you have hepatitis B it's important to protect others from infection. 
 
Important ways to prevent the spread of hepatitis B include:
 
  • vaccination of all close contacts (family members and sexual contacts)
  • practice safe sex (use condoms) until sexual contacts are fully vaccinated and immune
  • do not donate blood, organs or body tissue
  • do not allow your blood to contact another person (cover cuts, clean blood spills with bleach)
  • inform healthcare workers (including dentists)
  • if your work involves potential for your blood or other body fluid to spread to other people, discuss your situation with your doctor.
The hepatitis B vaccine is safe and effective in protecting against hepatitis B infection, providing protection in 95% of vaccinated people.
 
It's recommended that people who are at high risk of exposure, immunosuppressed or have other liver disease, be vaccinated against hepatitis B. Talk to your doctor about your level of risk and if vaccination is recommended for you.
 
Sources: Australian Immunisation Handbook, 2013; G. f. sheet, Hepatitis B, 2012; ncirs hepatitis B fact sheet; Royal Australian College of General Practitioners (RACGP) (AFP July 2013: Hepatitis B. What's new?)W. m. c. 2013, Hepatitis B fact sheet; World Health Organizsation (WHO)
Last reviewed: 
January, 2014