Hepatitis B

The hepatitis B virus is mainly spread through direct contact with infected blood and blood products, but you can also be infected through other body fluids including semen and vaginal fluids.

You can get hepatitis B:

• from a tiny amount of blood, too small to see
• by having vaginal, oral or anal sex with a person who has hepatitis B if you don’t use a condom or dam (a thin latex square held over the vaginal or anal area during oral sex)
• from sharing needles, syringes and other drug injecting equipment with a person who has hepatitis B
• if you have a job that involves possible contact with human blood or body fluids
• getting any body art, such as tattooing or piercing, when the equipment isn't sterile
• sharing personal items that can have traces of blood on them, such as razors, toothbrushes and dental floss.

About half of all adults and most children with hepatitis B have no symptoms at all. Some people feel well for several months before having any symptoms.

Symptoms include:

• fever
• extreme tiredness for weeks or months
• loss of appetite
• nausea (feeling sick) and vomiting
• joint pains
• eyes or skin turning yellow (jaundice).

A blood test can show you have been infected with hepatitis B in the past, and whether you are chronically infected. Other tests, such as liver function test, can show if any damage has been done to the liver.

See your doctor as soon as possible if you think you may have hepatitis B.

If you are exposed to hepatitis B, you should see your doctor immediately to assess the need for testing and vaccination.

There is treatment available for chronic hepatitis B that can reduce the progress of liver damage and loss of liver function. People with chronic hepatitis B should be monitored regularly (every 6-12 months) by their GP for signs and symptoms of liver disease.

If you have hepatitis B

You need to work with your doctor to look after yourself. Choose a doctor you are comfortable talking to and who has a good understanding of hepatitis B.

It is important not to pass hepatitis B onto anybody else. You can do this by:

• always using your own injecting equipment. Injecting equipment should be new and/or sterile
• using condoms, water-based lubricant and dams with new sexual partners, and with partners who are not already immune
• covering all wounds with a waterproof bandage
• being very careful to not expose other people to your blood or body fluids
• not donating blood, organs or tissues.

You need to minimise the risk of catching other liver infections, such as hepatitis A and hepatitis C. Ask your doctor about hepatitis A vaccination.

There are some other simple ways to protect yourself against hepatitis B and other infections:

• Avoid sharing needles, syringes or any drug injecting equipment. Wash your hands or wipe your fingers with a new alcohol swab before and after injecting yourself or another person. Always use new, sterile needles and syringes. You can get these from most chemists, needle and syringe exchanges, and at country hospitals after hours.
• Practise safe sex. Use a condom or dam and lubricant. The risk increases with the number of sexual partners, anal sex and/or sex during a woman’s period.
• Before considering any body art (such as tattooing or piercing) make sure the body artist uses only sterilised equipment, and new razors, inks, and needles each time.
• Don’t share personal hygiene items, such as razors, combs, nail brushes, and toothbrushes.
• Clean and cover any bleeding cuts and grazes immediately.
• Wear gloves and use paper towels (or disposable cloths) when cleaning up blood spills. Wash the area with soapy water, then wipe over with household bleach. Wrap the towels and gloves in a plastic bag before putting them in the bin.

Health care workers should always use infection control procedures at work.

Is there a vaccine for hepatitis B?

Yes, hepatitis B vaccination is safe and effective. You will be almost 100 per cent safe if you are fully vaccinated against hepatitis B. There are 3 injections over 6 months for adults.

Should I be vaccinated?

Since 2000, every baby born in Australia has been eligible to receive a free hepatitis B vaccine at birth and further doses at 2, 4 and 6 months of age.

Sexual partners of a person with chronic hepatitis B and people living with a person with chronic hepatitis B should be tested for hepatitis B. If not immune, they should be vaccinated.

Vaccination is free to some high-risk groups – ask your GP.

Hepatitis B vaccination is recommended if you:

• inject drugs
• get a tattoo or body piercing
• have unprotected vaginal, oral or anal sex with casual partners
• are a sex worker
• are a man who has sex with other men
• have HIV or any other chronic disease that impairs your immune system
• have a chronic liver disease (including chronic hepatitis C)
• are on kidney dialysis or have severely impaired kidney function
• are receiving certain blood products (e.g. people with clotting disorders who receive blood product concentrates, people with recurrent transfusion requirements)
• are receiving a solid organ or stem cell transplant
• attend or live in a residential care facility for people with developmental disabilities
• are an inmate of a custodial institution (prison)
• are a migrant from a country where hepatitis B is common
• travel to countries where hepatitis B is common (ask your GP or travel health specialist)
• are an Aboriginal or Torres Strait Islander person
• work in an industry that brings you into contact with blood or other body fluids
• are a health care worker.

Before you are vaccinated, your GP or health worker may take a blood test to see if you are already immune.