What is hepatitis B?

Hepatitis B (sometimes called 'hep B') is a liver infection caused by the hepatitis B virus. It can cause damage to your liver that can last a long time.

Hepatitis B can be acute or chronic. Acute hepatitis B lasts for less than 6 months. Chronic hepatitis B lasts for more than 6 months and is a lifelong illness.

Hepatitis B can be prevented with a vaccine.

What are the symptoms of hepatitis B?

You may not have any symptoms when first infected with hepatitis B.

You may notice signs such as:

• yellowing of the skin and eyes (jaundice)
• dark urine (wee)
• rashes
• fever

You may also experience symptoms such as:

• extreme fatigue (tiredness)
• nausea and vomiting
• muscle and joint pain
• loss of appetite
• pain in the right-hand side of the abdomen

Symptoms usually start 2 to 3 months after infection with the virus. Acute hepatitis B should go away after 3 to 6 months.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes hepatitis B?

Hepatitis B is caused by the hepatitis B virus. The virus can spread through blood and other bodily fluids. It can also spread through:

• sharing needles and other injecting drug equipment
• sharing razors, toothbrushes or nail clippers
• sexual contact (either heterosexual or homosexual)
• tattooing with unclean needles and equipment
• close family contact with someone who has hepatitis B
• accidental exposure, such as a needlestick injury or being splashed with infected blood or bodily fluid
• blood transfusion — this is now very rare as blood in Australia is screened for hepatitis B

A pregnant female may pass hepatitis B to their baby. This is screened for and treated during pregnancy in Australia. Babies are also given hepatitis B vaccines soon after birth.

You cannot catch hepatitis B by being coughed or sneezed on by infected people or by having contaminated food and drink. You cannot catch the virus from saliva (spit), breast milk or tears.

When should I see a doctor?

Many people do not have symptoms when they get hepatitis B and may never be diagnosed. Screening for hepatitis B is recommended for certain people, including:

• people who have injected drugs
• men who have sex with men
• people born in areas of the world where hepatitis B is common
• Aboriginal and/or Torres Strait Islander peoples
• people who have a suppressed (weak) immune system
• people with HIV or hepatitis C
• pregnant females

If you think you have been exposed to infected blood or bodily fluids, see a doctor as soon as possible. There are treatments that can reduce your risk of developing the infection if given soon after exposure.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How is hepatitis B diagnosed?

Hepatitis B is diagnosed with blood tests. These tests can tell if you:

• currently have a hepatitis B infection
• have a resolved hepatitis B infection
• are immunised against hepatitis B
• have liver damage from the infection

How is hepatitis B treated?

Treatment aims to maintain good health, but it does not cure the illness. During the acute phase of hepatitis B, your doctor may recommend rest, drinking enough fluids, and medicines to help with nausea if needed.

Not everyone with chronic hepatitis B needs treatment. Chronic hepatitis B without signs of liver damage will often not need treatment. It is still important to have regular medical checkups to watch for signs of liver damage. If you have liver damage, your doctor may recommend antiviral medicines. Antivirals help reduce the risk of developing liver disease in the long term.

If you have chronic hepatitis B, you may have to take medicine for the rest of your life. You may also need regular monitoring and screening for liver cancer.

If you have hepatitis B, you should drink plenty of fluids, eat a healthy balanced diet, get enough rest and avoid alcohol.

What if I am pregnant?

If you have hepatitis B and are pregnant, treatment can lower the chance of passing hepatitis B to your baby.

Your doctor will recommend a blood test for hepatitis B early in pregnancy, so you know if you need treatment.

What are the complications of hepatitis B?

The course of hepatitis B infection depends on the age at which a person is infected.

People infected as infants are likely to develop long-term (chronic) infection and can get complications such as scarring of the liver (cirrhosis), liver cancer or liver failure (when the liver stops working).

People infected as teenagers or adults are likely to become unwell with symptoms (acute hepatitis), but they have a smaller chance of developing a chronic infection. Some develop an infection without any symptoms.

Most people infected as adults 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.

People with chronic hepatitis B are at risk of developing complications such as cirrhosis and liver cancer in the long-term.

Can hepatitis B be prevented?

Hepatitis B can be prevented through vaccination and by reducing the risk of exposure to infected blood or body fluids.

Hepatitis B vaccine

Vaccination is your best protection against hepatitis B.

The hepatitis B vaccine is safe and effective in protecting against hepatitis B infection. In Australia, the hepatitis B vaccination is recommended for all children and those with increased risk, such as:

• people who live with or share living facilities with a person who has hepatitis B
• sexual partners of people with hepatitis B
• men who have sex with men
• people who are immunocompromised (have a weak immune system)
• people who inject drugs
• migrants from countries where hepatitis B is common or those travelling overseas to these countries
• Aboriginal and Torres Strait Islander peoples

Preventing the spread of hepatitis B

If you have hepatitis B, it is important to protect others from infection.

Ways to prevent the spread of hepatitis B include:

• practise safe sex (use condoms) until your 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 you have hepatitis B and your work involves the potential for your blood or other bodily fluid to spread to other people, discuss your situation with your doctor.

If your work involves blood or body fluids, including healthcare workers, police, sex workers, people in the military, funeral workers, tattooists and body piercers, your doctor may also recommend hepatitis B vaccination.

If you were not vaccinated against hepatitis B as a child, or if you are not sure if you are vaccinated, talk to your doctor about whether you need a catch-up vaccine.

This table explains how the vaccine is given, who should get it, and whether it is on the National Immunisation Program Schedule. Some diseases can be prevented with different vaccines, so talk to your doctor about which one is appropriate for you.

What age is it recommended?	Babies within 7 days of being born. Children aged 2 months, 4 months and 6 months. Others when their doctor advises they are at risk of catching hepatitis B.
How many doses are required?	3 or 4, depending on the vaccine.
How is it administered?	Injection
Is it free?	Free for babies under the National Immunisation Program. Free for people under 20 years old, refugees and other humanitarian entrants of any age. For everyone else, there is a cost for this vaccine. Find out more on the Department of Health website and the National Immunisation Program Schedule, and ask your doctor if you are eligible for additional free vaccines based on your situation or location.
Common side effects	The vaccine is very safe. Common side effects include soreness where the needle went in, low-grade fever and body aches.

Resources and support

• Hepatitis Australia has a range of helpful resources for people living with hepatitis B, including resources on your rights and responsibilities.
• Visit the Liver Foundation's website for information on staying healthy with a liver disease or call their free support line on 1800 841 118 to speak to a liver nurse.
• The National Hepatitis Infoline can direct you to confidential, free and localised viral hepatitis information and support services. Call on 1800 437 222 during their operating hours.

Languages other than English

• Hepatitis Australia has a range of information on hepatitis B available in several community languages.
• Allgood.org.au provides information on hepatitis B in languages other than English, as well as resources for Aboriginal and Torres Strait Islander communities.
• Hepatitis WA has a series of resources to help ask your doctor for information on hepatitis B testing and vaccines available in several community languages.
• LiverWELL has liver resources available in many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

• Hepatitis Queensland has several resources on hepatitis B available for Aboriginal and/or Torres Strait Islander peoples.
• Yarnin' about Hep B is a free booklet with information on hepatitis B.