If you have recently been exposed to hep B and have not been previously vaccinated, you can try to prevent the virus from taking hold by having a treatment of Hepatitis B Immunoglobulin and the hep B vaccination within 72 hours of being exposed. You can get these from your doctor, a sexual health clinic or a hospital.
If you have been previously vaccinated against hep B, your prior vaccination will protect you in case of an exposure to the virus.
The chances are that this won’t happen – ninety out of 100 adults exposed to hep B clear the virus within six months. These people will then be immune to hep B (they won’t get hep B again).
A further 5 out of 100 adults exposed to hep B will clear the virus within 12 months. These people will then be immune to hep B (they won’t get hep B again).
It’s only the remaining 5 out of 100 adults who would have chronic hep B.
For people living with chronic hep B, there is very effective treatment to help manage their hep B. To find out more about treatment for hep B check out our hep B treatment section or call the Hepatitis Infoline on 1800 803 990.
To find out if you’ve been vaccinated for hep B ask your doctor or sexual health clinic to test your immunity to hep B. Find a doctor or clinic.
If you were born in Australia after 2000, you’ve probably been vaccinated for hep B. Also, if you were in year 7 in Australia in 2004 or have started high-school since then, you’ve probably been vaccinated for hep B.
It is a good idea to visit a doctor and have a liver check every 12 months. This will help you and your doctor to know how hep B is affecting your liver health. This will probably include a Liver Function Test and a hep B DNA test to check your viral load. Find a doctor near you.
You might need to visit your doctor more frequently if you have liver damage. Talk to your doctor about referral to a liver clinic for treatment to give yourself the best chance at living well with hep B.
Regular liver ultrasounds are recommended for people living with chronic hep B. This is because chronic hep B can cause liver cancer. Regular ultrasounds can help diagnose liver cancer at an early stage, which means it can be treated.
Check out the Hepatitis B Bear resource for detailed information on the different phases of chronic hep B
To avoid passing on hep B the most important thing you can do is make sure that your family members and sexual partners have the hep B vaccination. Some of the following suggestions might be useful:
- Practice safer sex by using protection during sex. Use condoms when having oral, anal or vaginal sex. Use dental dams when having oral sex. Condoms and dams help to prevent your partner being exposed to hep B. You can get free condoms and dams from sexual health clinics.
- Avoid sharing your personal-care items such as razors, toothbrushes, nail-clippers or anything that might come into contact with blood. Keep them in a bathroom bag that you keep in your room or on a high shelf in the bathroom.
- Avoid sharing injecting equipment if you’re injecting drugs. Use your own equipment every time and avoid sharing any equipment – this will make it very unlikely that you’ll pass on hep B. This includes needles, syringes, water, spoons, alcohol swabs, tourniquets, filters and cotton-balls.
- Use standard first-aid practices. Ensure that any cuts are covered with band-aids, and that wipes or bandages that might have come into contact with blood are disposed of in plastic bags.
You can’t get hep B from:
- hugging or kissing
- another person’s tears or sneezes
- sharing cups, plates, clothes, food, showers or toilets
- mosquito bites
To give your child the best chance at avoiding hep B your baby needs to be given two injections within the first 12 hours after they’re born. One is hepatitis B immunoglobulin (HBIG) and the other is the first dose of the hep B vaccine.
If the baby is given both injections (plus three follow-up doses of hep B vaccine over the next six months) the risk of hep B being passed on from mother to child is extremely low. Without HBIG and vaccination, the risk of transmission could be as high as 9 babies out of every ten. Women living with hep B during a pregnancy will have their level of virus (hep B DNA level) checked. Women with very high levels of hep B may be offered additional medicine during pregnancy to minimise the risk of passing on the infection to the baby.
Talk to your doctor or birthing staff about your hep B and ask that your baby be given the treatment called immunoglobulin.
If your baby is given hep B immunoglobulin and hep B vaccination within 12 hours of birth, there is no need to avoid breastfeeding. Breastfeeding is highly recommended as it is the best source of nutrients for your baby.
The hep B vaccination is recommended for many people, some of whom are able to access the hep B vaccination for free.
Consider being vaccinated for hep B if you are:
- a person who injects drugs
- a man who has sex with men
- have sex with someone with hepatitis B
- in household contact with someone who has hepatitis B
- on haemodialysis
- someone with HIV or impaired immunity
- have some other type of liver disease
- someone with a clotting disorder
- waiting for a liver transplant
- traveling to countries where hepatitis B is endemic
- adopting children from overseas who have hepatitis B
- going to be in prison
Consider being vaccinated for hep B if you work as:
- a sex worker
- a staff-member in a facility for people with intellectual disabilities
- a juvenile justice or prison worker
- a healthcare worker, ambulance personnel, dentist, embalmer, tattooist or body-piercer
- a police officer, member of the armed forces or emergency services worker
- a funeral worker (or other worker who has regular contact with human tissue, blood or body fluids and/or uses needles or syringes)
You might also consider being vaccinated if you are:
- someone who plays contact sports (low risk)
NSW Health funds free hep B vaccination for the following groups:
- all newly born babies
- household contacts of people with acute and chronic hepatitis B
- refugees (adults and children)
- sex workers
- people living with HIV
- men who have sex with men
- People who inject drugs
- catch up of Aboriginal persons 20 years of age or older
- clients of sexual health services, opioid programs and s100 prescribers
- catch up of Aboriginal children under 20 years of age
- children in Year-7 only who missed out on vaccination at school until the end of 2013
- catch up of children less than 7 years of age born overseas.
For the rest of 2013 anyone under 18 years of age can still access free hep B vaccination through their doctor or sexual health clinic. After 2013 it may no longer be free to be vaccinated against hep B.
Important note: One month after you have completed the three doses of hepatitis B vaccine it is important to have a blood test to check that you have developed immunity. A small number of people (less than 5%) will not develop immunity and may require booster shots.
If you have acute hepB you might not experience any symptoms. If you do, they can take up to three months to appear, and are likely to make you sick for between 1-3 months. During that time you might experience symptoms such as:
- weight loss
- feeling like you have a flu
- dark urine
It may take several months for you to recover. The older a person is when they get hep B, the better their chances of successfully fighting it off (‘clearing’ the virus).
Around 95% of adults who contract hep B will only have an acute infection and are able to clear it naturally. On the other hand, up to 90% of babies and 30% of children who get the virus will go on to have chronic hep B. Many people with acute hep B will have no symptoms and wouldn’t ever realise they had the infection.
No. If your body has naturally fought off (cleared) hep B, then you will be immune for life. This means you cannot get it again and you cannot pass it on.
If you have chronic hep B it is a lifelong illness.
Each person’s experience of the illness is different, and depends on a number of factors like what stage their hepatitis B is currently in and how long they’ve had the virus.
Between 20 to 30% of people with chronic hep B will develop advanced liver disease if the virus is left untreated. Advanced liver disease can cause complications including liver failure and liver cancer, and can lead to death.
Most people with chronic hep B do not have any symptoms of infection which means they may feel healthy and not be aware they are infected. Some other people may experience symptoms which are similar to those experienced with other forms of viral hepatitis. These can include:
- tiredness, depression and irritability
- pain in the liver (upper, right side of abdomen)
- nausea and vomiting
- loss of appetite
- joint aches and pains
If you have chronic hep B you are at risk of developing liver cancer. Your doctor may recommend that you have an ultrasound scan of the liver every 6 months. If a small liver cancer develops, it can be treated more easily if found early.
You might have been told that you’re a “carrier” or that your hep B is not active. This refers to you being in a particular phase of the infection.
However, the activity of your Hep B can change over time. It is a good idea to have a liver check every 12 months to keep an eye on your liver and your hep B. This should include a Liver Function Test and a HBV DNA test to check your viral load.
These tests tell you which phase of the infection you are in (it changes). At some stages the virus appears to be less active than others and may be less likely to be passed on.
Check out the Hepatitis B Bear resource for detailed information on the different phases of chronic hep B.
Not everyone with hep B needs treatment. The treatments for hep B aim to stop the virus being active and multiplying in the liver. Treatment aims to decrease the amount of the virus in your blood (your “viral load”) so that your immune system can make the virus inactive.
The amount of virus in your blood will depend on which phase of the infection you are in, so you may need treatment at some times and not others. Most people who start treatment for chronic hep B will be on it long-term.
Treatment cannot cure hep B: the goal is to control the virus by making it inactive.
In Australia there are a number of drugs used to treat hep B:
Entecavir (Baraclude®) and Tenofovir (Viread®) are two newer antiviral medications which are generally more potent (stronger). They are also taken orally, usually very well-tolerated (unlikely to cause side effects), and the virus is much less likely to become resistant to them with prolonged use.
Pegylated interferon boosts the body’s immune system and changes the virus’ ability to multiply. It is a synthetic version of a protein our bodies naturally produce (interferon). Pegylated interferon is injected under the skin once a week for up to twelve months. Several other drugs are available but are less effective and not as commonly used.
For most people, treatment is long term and it is really important not to stop treatment without advice from your treating doctor.
Ask your doctor for regular liver tests (about every 12 months) even if you feel well.
Talk to your doctor before taking any herbal or complementary medicines as some are harmful to the liver.
Get some regular exercise and eat fresh fruit and vegetables every day – a healthy body weight will help keep your liver healthy too.
Alcohol and tobacco are both harmful to your liver. If you regularly drink alcohol or smoke tobacco, then talk to your doctor about what is available to help you to cut down or stop. You can also call the Alcohol Drug Information Service (ADIS) NSW for support, information, counselling and referral to services in NSW on 1800 422 599.
Heavy or daily use of marijuana (pot) is also harmful to your liver. If you smoke pot regularly, then think about cutting down or stopping to help look after your liver. You can call the Cannabis Helpline on 1800 30 40 50 to get some help with it.
If you’re living with hep B you can work most places, including childcare and healthcare. There may be restrictions about the kinds of healthcare you can perform – depending on your viral status, you can’t perform “exposure-prone procedures”.
If you are asked to disclose that you have hep B on a job application you don’t have to answer unless you are:
- applying to join the army, navy or air-force
- applying for a job in which you would be performing exposure-prone procedures (putting your hands inside people’s bodies where you cannot see your hands – internal surgery).
- if you are applying for a position with NSW Health you will be asked to provide proof that you have been vaccinated against hep B. You may also need to provide evidence that you know of your hep B viral status with your application.
You can get more advice from the HIV/AIDS Legal Centre (HALC) – they offer advice about hep B. You can call HALC Monday to Friday between 10am to 6pm on 9206 2060. You can also submit a question online here.
The Hepatitis Infoline 1800 803 990 can provide you with more information, and can also direct you towards doctors and specialists in your area. You can call the Hepatitis Infoline through the Telephone Interpreter Service 131 450. We can send you printed information, including information in community languages.
It is a good idea for people with hep B to be in regular contact with a doctor and a liver specialist. You can search our directory to find your nearest liver clinic.
The following websites might be helpful
Hepatitis B Help has information people living with hep B and for doctors.
HBV Advocate has information for people living with hep B, including information in community languages.
ASHM has information for doctors and policy information on hep B.
This page was last updated 07 June 2016.
Primary sources for this page: HIV, Viral Hepatitis & STIs – a Guide for Primary Health Care (ASHM 2014), Hepatitis B Bear and You – Information about the different phases of hepatitis B infection (Dr Miriam Levy, Liverpool Hospital, 2013)