Hepatitis B
Hepatitis B
About hepatitis B
Hepatitis means ‘inflammation of the liver’. Hepatitis B (also referred to as hep B) is caused by the hepatitis B virus (HBV) and is an infection that can lead to serious
liver problems
such as
liver cirrhosis
and
liver cancer
.
The virus is found in blood and, to a lesser degree, in body fluids such as semen and vaginal secretions.
You can get hepatitis B by having unsafe sex, sharing unsterile piercing or drug injecting equipment, or engaging in other activities where the blood or body fluids of a person living with hepatitis B enters the bloodstream of another person. The virus may also be passed from a pregnant mother to her baby. In about 30 to 40% of cases, infections occur without a known cause.
Children who get hepatitis B are more likely to have ongoing infection and therefore more likely to develop liver disease or cancer in later life. Most adults who have hepatitis B recover completely (clear the virus) and do not require ongoing treatment.
All children born in Australia after 2000 were given
immunisation for hepatitis B
as part of the
childhood immunisation
schedule. All children and adults at increased risk should be immunised against hepatitis B.
Symptoms of hepatitis B
Most people have no symptoms when they are first infected with hepatitis B.
Some people who are newly infected or have been living with hepatitis B for a long time may have mild, flu-like symptoms, while some do not become sick at all.
Many people with chronic hepatitis B (defined as infection that persists for at least 6 months) may have had the virus since birth or early childhood, and do not experience symptoms, or are not aware that the symptoms they experience are abnormal, as the symptoms may differ in severity and intensity over time.
In more severe cases, hepatitis B can cause:
loss of appetite
nausea and vomiting
discomfort or pain in the liver (under the right ribcage)
fever
pain in the joints
jaundice (the eyes and skin become yellow).
Normally, these symptoms disappear in a few weeks, but even when the person feels much better, they may still be infectious.
Most adults who are exposed to the hepatitis B virus recover completely, and no longer have the virus. Some people become very ill in the time just after exposure to the virus and need to go to hospital; some may even die.
Complications of hepatitis B
A small proportion of people exposed to the hepatitis B virus develop a long-term (chronic) hepatitis B infection. They may have the virus in their bloodstream for most of their life without realising they live with an ongoing infection.
People with chronic hepatitis B infection may not notice any health problems until they develop liver problems such as liver disease (scarring or cirrhosis) or liver cancer later in life.
Treatment for hepatitis B is essential because it is not possible to be a ‘healthy carrier’ of the hepatitis B virus.
Chronic hepatitis B infection occurs more commonly in some communities, including:
Aboriginal and Torres Strait Islander communities
in people from parts of the world where hepatitis B is more common, such as:
North-East Asia
South-East Asia
Mediterranean Europe
North Africa
Middle East
Pacific Islands
Sub-Saharan Africa.
Causes of hepatitis B
Hepatitis B is transmitted through contact with blood that contains the hepatitis B virus. If infected blood or body fluids enter another person’s bloodstream, that person may become infected.
The time from exposure to the hepatitis B virus to the appearance of the illness (if symptoms occur) is 45 to 180 days.
Risky activities that can cause infection include:
sharing unsterile or unclean equipment for injecting drugs
piercing the skin with equipment that is not properly cleaned, disinfected and sterilised
sharing razor blades or toothbrushes
coming into contact with infected blood through open cuts or the mucous membranes of another person
having
unprotected sex
(for example, without a condom), especially if there is blood present.
Mothers who have hepatitis B can pass the virus to their babies or children at the time of birth or after birth. If the newborn baby is quickly
immunised
with 2 vaccines, they can be protected from getting hepatitis B.
All blood and blood products produced for medical purposes in Australia are carefully screened for hepatitis B and other blood-borne viruses. The risk of getting infected with hepatitis B from a
blood transfusion
is extremely low (approximately 1 in 764,000).
Reducing the risk of hepatitis B
Simple steps that everyone can take to protect themselves against hepatitis B include:
Make sure you and your children are
immunised
– this is the best protection.
Use condoms
every time you have anal or vaginal sex with new partners until you both get a check-up (this also prevents against other infections).
Avoid
oral sex
if you or your partner have
herpes
, ulcers or bleeding gums – it is unlikely that you will contract hepatitis through oral sex unless blood is present.
Choose to have any
body piercing
or
tattooing
done by an experienced practitioner who follows good sterilisation and hygiene practices, and who works at premises registered by the local council.
Wear single-use gloves if you give someone first aid or need to clean up blood or body fluids.
Never share needles and syringes or other equipment (such as spoons, swabs or water), if you inject drugs. Always use sterile needles and syringes. These are available from needle and syringe programs and some pharmacists. Always wash your hands before and after injecting.
If you have hepatitis B:
Make sure your partner and close contacts are
immunised against hepatitis B
so you don’t have to worry about hepatitis B passing to others in your home.
Avoid sharing injecting equipment or personal items (such as toothbrushes or razors).
Completely cover any cut or wound with a waterproof dressing.
Practise
safe sex
until you know your partner is immunised and protected.
Consider discussing your condition with your healthcare professional when undergoing any medical or dental procedure, although there is no legal obligation to do so.
If you think you have been exposed to hepatitis B, see a doctor immediately. Your doctor can give you treatment in some instances, which greatly reduces the risk of you becoming infected with hepatitis B.
Diagnosis of hepatitis B
Blood tests
are available to determine if you are or have been infected with hepatitis B. It may take 6 months from the time of infection before a blood test can detect antibodies to hepatitis B, so follow-up testing may be required. During this 6-month period, until you know whether you are infected or not, take action to prevent potential infection of other people.
There are also tests that can assess liver damage from hepatitis B such as the liver function test, fibroscan, ultrasound and liver biopsy.
It is recommended that all pregnant women test for hepatitis B. If you are living with chronic hepatitis B, your doctor can help reduce the risk of transferring the virus to your newborn child.
Check-ups and treatment for hepatitis B
All people living with long term (chronic) hepatitis B require
regular check-ups
, but only some require regular medicine (antiviral medications, some of which are covered by the
Pharmaceutical Benefits Scheme
). Medicine for hepatitis B controls the amount of virus in the body but does not clear or cure the person of the infection.
People whose bodies are naturally maintaining low levels of the virus in their blood and who have no sign of liver damage do not need to be on medication for hepatitis B.
People who have high levels of the virus or some liver damage can have treatment that will control and reduce the amount of virus in their body, prevent liver damage and help to heal their scarred liver.
Your body’s ability to control the virus can change, so you may need medication at some times, and not at others.
Talk to your doctor or specialist to understand whether you need treatment for your liver or not.
While not everyone living with long-term hepatitis B requires medications, all people with long-term hepatitis B need to have regular check-ups for their hepatitis B, every 6 to 12 months.
If you have long-term hepatitis B, consult with your doctor. They will monitor your condition and, if necessary, refer you to a specialist.
You can also help to keep your liver healthy by:
limiting how much
alcohol
you drink
quitting smoking
eating a
well-balanced, low-fat diet
staying active
managing
stress
.
Immunisation for hepatitis B
Immunisation is the best protection against hepatitis B infection. A course of vaccination is recommended for all babies and people in high-risk groups.
Immunisation can be with a
vaccine against hepatitis B alone
or with a combination vaccine. To be immunised, contact your doctor or local council.
Protection against hepatitis B is available free of charge under the
National Immunisation Program
Schedule
External Link
. In Victoria, immunisation against hepatitis B is free for:
babies at birth – immunisation against hepatitis B alone as soon as possible after birth
babies at 2, 4 and 6 months –
combination immunisation
in the form of a diphtheria, tetanus, whooping cough, hepatitis B, polio and
Haemophilus influenzae
type b (Hib) vaccine (six-in-one vaccine)
premature babies at 12 months – premature babies born under 32 weeks gestation or under 2,000g birth weight receive a single booster dose
children
up to and including 9 years of age
people aged less than 20 years having a
catch-up immunisation
refugees and humanitarian entrants aged 20 years and above.
In Victoria, free hepatitis B vaccine is provided for people who are at increased risk of infection, including:
household contacts and sexual partners of people living with hepatitis B
people who inject drugs or are on opioid substitution therapy
people living with
hepatitis C
men who have sex with men
people living with
HIV
prisoners and people on remand who do not have hepatitis B or immunity against hepatitis B
people no longer in a custodial setting who commenced, but did not complete, a free vaccine course while in custody
Aboriginal and Torres Strait Islander people
vulnerable people who have experienced socioeconomic disadvantage that compromised their equitable access to the vaccine, aged 20 years and above (this is based on an individual assessment by the immunisation provider)
people who arrived in the last 10 years from countries where hepatitis B is endemic (including China, Philippines, Malaysia, Vietnam, Afghanistan, Thailand, South Korea, Myanmar, Indonesia, Singapore, Hong Kong, Taiwan and Cambodia).
Immunisation is also recommended, but not necessarily free, for people who are at increased risk of infection, including:
healthcare or emergency workers, or members of the police force or armed forces
workers who come into regular contact with blood and other body fluids or tissue such as funeral workers, embalmers, tattooists, and people who come into regular contact with used needles or syringes
workers in the sex industry
people from countries where hepatitis B is prevalent, including Africa, Asia, Russia and Eastern Europe
adults on haemodialysis and people with severely impaired renal function in whom dialysis is anticipated
solid organ and haematopoietic stem cell transplant recipients
immunocompromised adults
people with a blood-clotting disorder or who require ongoing transfusions with blood products
people who have more than one sexual partner
people with chronic liver disease or a liver transplant
residents or staff members at facilities for people with developmental disabilities
travellers to hepatitis B endemic areas either long-term or for frequent short visits, or undertaking activities that increase their risk of exposure
people with a history of injecting drug use.
Remember that being immunised against hepatitis B does not protect you against HIV, hepatitis C or other diseases spread by blood or body fluids, so you still need to take precautions to ensure you are not exposed to these diseases.
Pregnancy and hepatitis B immunisation
Hepatitis B vaccine is not usually recommended for
women who are pregnant
or breastfeeding, but could be recommended by your doctor if you are not immune to hepatitis B and you are at increased risk of infection.
Where to get help
In an emergency, always call triple zero (000)
Emergency department of your nearest hospital
Your
GP (doctor)
Your local community health centre
Your local government immunisation service
Maternal and Child Health Line
Tel.
13 22 29
(24 hours, 7 days)
Nurse-on-Call
Tel.
1300 60 60 24
– for expert health information and advice (24 hours, 7 days)
National Immunisation Information
Line
External Link
Tel.
1800 671 811
DirectLine
External Link
Tel.
1800 888 236
– for 24-hour confidential drug and alcohol telephone counselling and referral (including information about where to get clean needles and syringes)
Melbourne Sexual Health
Centre
External Link
Tel.
(03) 9341 6200
or
1800 032 017
Victorian Sexual Health Network – where to get
tested
External Link
– visit Melbourne Sexual Health Centre’s GP partner clinics for STI check-ups and treatment
Your local
pharmacist
SAEFVIC
External Link
Tel.
1300 882 924
Immunisation Unit, Department of Health, Victorian Government Email:
immunisation@health.vic.gov.au
LiverWELL
External Link
Tel.
1800 703 003
St Vincent’s Hospital, Melbourne – ‘Treatment for hepatitis B’ available in English, Simplified and Traditional Chinese and
Vietnamese
External Link
Community Pharmacist Pilot
– receive some treatments at a local pharmacy without needing to see a doctor for a prescription in Victoria