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Disease

Hepatitis B

Page last updated on 05 December 2018

In 2017 there were 6,122 cases of hepatitis B recorded in Australia, of which 142 cases were “newly acquired” and 5,980 cases were “unspecified” in regards to the time lapse since first infection.

Hepatitis B (also called hep B) is a viral infection of the liver. It is most commonly contracted through sex, sharing needles, and in less common cases from tattoos and body piercing in which equipment was exposed to contaminated blood.

Most adults will fully recover from the infection, however, this is not usually the case in young children. In most people, hepatitis B can be effectively prevented through vaccination.

Hepatitis B is most common in some countries in Asia, Africa, South America and the Caribbean. If you are travelling overseas to any of these destinations, then you should speak to your healthcare professional regarding prevention measures. 

Key disease information

What is hepatitis B?

Hepatitis B (also called hep B) is a virus that infects the liver. The virus can be found in blood and bodily fluids, including semen and vaginal fluid. 

Hepatitis B (also called hep B) is caused by a virus that infects the liver. The virus can be found in blood and bodily fluids, including semen and vaginal fluid. 

As the hepatitis B virus infects the liver, symptoms often include abdominal pain (right side) and dark coloured urine. However, some people will experience no signs or symptoms of infection. 

Most adults will fully recover from a hepatitis B infection; however, if left untreated some will develop a long lasting, chronic infection. 

Most young children do not recover from a hepatitis B infection and will have the disease for the rest of their lives. 

Vaccination is the best way to prevent getting hepatitis B.

How is hepatitis B spread?

Hepatitis B is spread through contact with blood and bodily fluids, including semen and vaginal fluid. Therefore, you may be exposed to the hepatitis B virus through unprotected sex (without a condom), or through sharing needles for drug injection, or through acupuncture, body piercing and tattooing, if proper sterility and hygiene practices are not followed. 

Hepatitis B may also be transferred from a mother to baby during birth or in the time after birth. 

In less common cases, hepatitis B may also be spread by contact with personal items such as contaminated razors and toothbrushes.

Due to screening of blood products and organs for transplant, contracting hepatitis B through a blood transfusion or organ transplant is not likely in Australia.

Is hepatitis B contagious?

Yes. Hepatitis B can be easily spread from person to person via contact with blood or bodily fluids, including semen and vaginal fluids.

There are precautions you can take to reduce your risk of hepatitis B infection:

  • Ensuring you and your family are immunised against hepatitis B
  • Use condoms every time you have anal or vaginal intercourse
  • Avoid oral sex if you or your partner has herpes, ulcers or bleeding gums
  • Only receive piercings or tattoos from experienced practitioners who follow good sterilisation and hygiene practices
  • Wear disposable gloves if you need to give someone first aid or to clean up blood or other bodily fluids
  • Never share needles, syringes, spoons, swabs or water if you inject drugs.
     

If you have hepatitis B, you can reduce the risk of transmitting the virus by:

  • Avoiding sharing personal items such as toothbrushes and razors
  • Ensure close contacts are immunised against hepatitis B
  • Cover any wounds with waterproof dressings
  • Practise safe sex
  • Consider discussing your condition with your healthcare professional when undergoing any procedures.
     
What are the symptoms of hepatitis B?

Symptoms are that of hepatitis (inflammation of the liver) including:

  • Fever
  • Malaise (generally feeling unwell)
  • Abdominal pain (particularly right side, under the ribs)
  • Nausea, vomiting, and loss of appetite
  • Dark coloured urine
  • Clay (light) coloured stool (poo)
  • Myalgia (muscle aches)
  • Jaundice (yellowing of the skin and eyes).

Hepatitis B may present with no symptoms, which means the person may not know they have the infection and may be unwittingly spreading the virus to other people. 

In most cases the symptoms (if present) appear three months after initial exposure to the virus, however, this can range from six weeks to six months. Most adults will make a complete recovery from the infection; however, most infants and about half of young children will persist to a chronic infection for the rest of their lives. 

Chronic hepatitis B infection carries with it an increased risk of liver cirrhosis (scarring) and liver cancer.

What countries are affected by hepatitis B?

North America, Northern Europe and Australia have a low incidence of hepatitis B. Countries in the Mediterranean, parts of Eastern Europe, Africa, Central and South America have higher rates. The highest rates of hepatitis B exist in sub-Saharan Africa, South East Asia and the Pacific Islands. 

If you are travelling to countries with higher incidences of hepatitis B or those which may not screen their blood supply in case of a blood transfusion, there are several precautions you can take:

  • Get immunised before you travel
  • Practise safe sex – use condoms correctly
  • Do not share drug-injecting equipment
  • Limit alcohol consumption as people tend to take more risks when intoxicated
  • Do not share toothbrushes, razors, piercings or needles
  • Avoid tattoos and acupuncture unless you are sure they equipment is appropriately sterilised
  • Before any medical or dental procedures, ensure equipment used is sterilised appropriately.
How can hepatitis B be prevented?

Hepatitis B is a vaccine-preventable disease.

In Australia, it is recommended that babies are vaccinated at birth and then at 2, 4 and 6 months of age. The vaccination is provided free as part of the National Immunisation Program (NIP).

Immunisation is also recommended for all healthcare workers in Australia and for those travelling overseas to regions where the disease is more prevalent. The vaccine is an important preventative measure for Australians travelling to developing countries, where health standards may be lower, putting travellers at risk if they suffer injuries or an accident that requires a visit to a hospital. Australian travellers are advised to visit their General Practitioner (GP) or travel medicine specialist 4-6 weeks before travelling overseas to discuss suitable vaccination options.

Vaccination is also recommended for individuals who may take part in high risk activities, such as unprotected sex with new partners, those receiving tattoos or piercings in countries with lower sanitation practices or those who practice drug use (sharing of needles).

Women considering becoming pregnant should talk to their healthcare professional about prenatal screening for hepatitis B.

It also recommended to always practice safe sex (i.e. using condoms), especially with new partners or if you have sex with several partners, and to not use illegal drugs and/or share needles. 

I’m getting tattooed, do I need a hepatitis B vaccine?

All Australian children should be receiving hepatitis B vaccines as part of the National Immunisation Program (NIP). So, if you were born after 1996 you may already have been vaccinated.

If you are getting a tattoo in Australia, it is likely that the tattoo artist is following the standard practices for infection control. A few ways that you can ensure this includes making sure: 

  • Your tattoo artist is registered with the local council.
  • Your tattoo artist knows the industry Code of Practice.
  • The premises of your tattoo artist are clean and properly equipped with items for personal hygiene, cleaning and sterility, including a bench-top steriliser (steam autoclave).
  • Needles are single use only.
  • Sterilised equipment is opened just before use.
  • Pigments and dyes are in single use vessels only.
  • Your tattoo artist cleans and disinfects your skin before they start.
  • Your tattoo artist washes their hands and wears clean, disposable gloves while they work.

If you are getting a tattoo while overseas, hepatitis B and other blood-borne diseases (e.g. HIV and hepatitis C) may be more common in the country you are travelling to and the country may not have the same infection control practices as we have in Australia. Speak with your doctor at least 6-8 weeks prior to your departure to ensure you are protected from diseases while overseas. 

VaccineHub offers general information only. Please see a healthcare professional for medical advice

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Sources & Citations

  1. Australian Government, Department of Health, Australian Immunisation Handbook 10th Edition, 4.5 Hepatitis B. Available at http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-5 (accessed 5 April 2018).
  2. Australian Government, Department of Health, National Immunisation Programme Schedule. Available at https://beta.health.gov.au/topics/immunisation/immunisation-throughout-life/national-immunisation-program-schedule (accessed 5 April 2018).
  3. NSW Government, Department of Health, Hepatitis B fact sheet. Available at http://www.health.nsw.gov.au/Infectious/factsheets/Pages/hepatitis_b.aspx (accessed 5 April 2018).
  4. World Health Organisation, Hepatitis Fact Sheet. Available at http://www.who.int/mediacentre/factsheets/fs204/en/ (accessed 6 April 2018).
  5. Victorian State Government, Better Health Channel, Hepatitis B. Available at https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hepatitis-b (accessed 5 April 2018).
  6. Centers for Disease Control and Prevention, Hepatitis B FAQs for the Public. Available at https://www.cdc.gov/hepatitis/hbv/bfaq.htm (accessed 5 April 2018).
  7. World Health Organisation, Global Hepatitis Report, 2017. Available at http://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/ (accessed 6 April 2018).
  8. Australian Government, Department of Health, Healthy Body Art. Available at http://www.health.gov.au/internet/main/publishing.nsf/content/ohp-bbvs-bodyart2011 (accessed 6 April 2018).
  9. NSW Government, Department of Health, Tattooing and other body art - hygiene standards. Available at http://www.health.nsw.gov.au/environment/factsheets/Pages/tattooing.aspx (accessed 6 April 2018).
  10. Centers for Disease Control and Prevention, Hepatitis B. Available at https://wwwnc.cdc.gov/travel/diseases/hepatitis-b (accessed 5 April 2018).
  11. Australian Government. Department of Health. National Notafiable Diseases Surveillance System. Number of notifications for all diseases by year, Australia, 1991 to 2017 and year-to-date notifications for 2018. Available at: http://www9.health.gov.au/cda/source/rpt_2.cfm (accessed 3 May 2018).

SPANZ.SAPAS.18.04.0173 - Date of preparation May 2018

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