What Is Hepatitis B?
A viral liver infection transmitted through blood and body fluids, capable of causing chronic liver disease and liver cancer.
Pathogen: Hepatitis B virus (HBV, Hepadnaviridae family)
Type: Virus
Transmission
Contact with infected blood and body fluids through sexual contact, needlestick injuries, unsterile medical or dental procedures, tattooing and piercing with unsterile equipment, sharing razors or toothbrushes, and from mother to baby during birth.
Vector: No arthropod vector. Blood-borne and sexually transmitted.
Symptoms
Many infections are asymptomatic, especially in children. Symptomatic acute infection causes fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and jaundice. Fulminant hepatitis (acute liver failure) occurs in <1% of cases.
Incubation period: 45 – 180 days
Average 90 days (range 45-180 days). Longest incubation of common hepatitis viruses.
Timeline: Symptoms develop 6 weeks to 6 months after exposure. Acute illness lasts 1-3 months. 95% of adults clear the virus completely. Chronic infection develops in 5% of adults but up to 90% of infected infants.
Case fatality rate: Acute hepatitis B: <1% (fulminant hepatitis). Chronic hepatitis B: 15-25% die of cirrhosis or hepatocellular carcinoma over decades.
Diagnosis & Treatment
Diagnosis: Hepatitis B surface antigen (HBsAg) indicates current infection. Anti-HBs antibody indicates immunity (from vaccination or past infection). HBeAg and HBV DNA levels indicate viral replication and infectivity. Anti-HBc IgM indicates acute infection.
Treatment: Acute hepatitis B: supportive care (rest, hydration, avoid alcohol). Chronic hepatitis B: antiviral therapy with entecavir or tenofovir to suppress viral replication and reduce risk of cirrhosis and liver cancer. Pegylated interferon is an alternative. Treatment is long-term, often lifelong.
Prevention
- Hepatitis B vaccination (3-dose course, or combination hep A/B vaccine)
- Use condoms for sexual contact with new partners
- Avoid unsterile medical, dental, tattooing, or piercing procedures
- Do not share razors, toothbrushes, or needles
- Carry a personal medical kit for travel (sterile needles, syringes)
- Ensure any medical treatment abroad uses sterile single-use equipment
💉 Vaccine Available
A vaccine is available for Hepatitis B. View the Hepatitis B vaccine guide for details on schedule, cost, and availability in Australia.
Post-Exposure
Hepatitis B immunoglobulin (HBIG) plus vaccination should be given as soon as possible (ideally within 24 hours) after exposure for unvaccinated individuals. Vaccinated individuals with confirmed immunity (anti-HBs ≥10 mIU/mL) do not need post-exposure prophylaxis.
Long-Term Effects
Chronic hepatitis B develops in about 5% of adults infected. It can lead to cirrhosis (20-30% of chronic carriers), hepatocellular carcinoma (liver cancer), liver failure, and death. Regular monitoring with liver function tests, viral load, and liver ultrasound is essential for chronic carriers.
📋 Hepatitis B is a nationally notifiable disease in Australia. Both newly acquired and unspecified infections are notifiable. The hepatitis B vaccine has been on the National Immunisation Program since 2000 (birth dose plus infant series).
Frequently Asked Questions
Am I already vaccinated for hepatitis B?
If you were born in Australia after May 2000, you likely received the hepatitis B vaccine as part of the childhood immunisation schedule (birth dose plus 3 infant doses). If you were born before 2000, you may have been vaccinated in high school (a catch-up program ran in the early 2000s) or not at all. Check your immunisation history on the Australian Immunisation Register (AIR) via MyGov, or ask your GP for a blood test to check your immunity (anti-HBs antibody level).
How is hepatitis B transmitted while travelling?
Common travel-related exposures include sexual contact with a new partner, unsterile medical or dental treatment, tattooing or piercing with reused equipment, sharing razors, and needlestick injuries. Even a minor medical procedure, blood test, or dental visit in a country with poor infection control can pose a risk. Carrying a sterile medical kit is a sensible precaution.
Can you get hepatitis B from a tattoo in Bali?
Yes. Getting a tattoo or piercing with unsterile equipment is a well-documented route of hepatitis B (and hepatitis C) transmission. The risk is higher in countries where infection control standards may be inconsistent. If you plan to get a tattoo overseas, ensure the studio uses single-use disposable needles and sterilised equipment. Being vaccinated against hepatitis B before travel is the best protection.
How many doses of hepatitis B vaccine do I need?
The standard course is 3 doses at 0, 1, and 6 months. An accelerated schedule (0, 7, and 21 days with a booster at 12 months) is available for last-minute travellers. The combination hepatitis A/B vaccine (Twinrix) requires 3 doses at 0, 1, and 6 months, or an accelerated 4-dose schedule. After completing the course, immunity is long-lasting and boosters are not routinely recommended.
Is hepatitis B curable?
Acute hepatitis B: 95% of adults clear the virus completely and develop lifelong immunity. Chronic hepatitis B (affecting about 5% of infected adults): there is no cure, but antiviral medications can effectively suppress the virus, reducing the risk of cirrhosis and liver cancer. Treatment is typically lifelong. Research into curative therapies is ongoing.
Do I need a hepatitis B booster before travel?
If you completed a full vaccination course and had a documented response (anti-HBs ≥10 mIU/mL), booster doses are generally not recommended for immunocompetent individuals, even decades later. The immune memory persists. However, if you are unsure of your vaccination status, a blood test (anti-HBs) can confirm your immunity, and a booster or full course can be given if needed.
What is the difference between hepatitis A and hepatitis B?
Hepatitis A is spread through contaminated food and water, causes acute illness only (no chronic infection), and is prevented by the hepatitis A vaccine. Hepatitis B is spread through blood and body fluids, can cause chronic liver disease and liver cancer, and is prevented by the hepatitis B vaccine. Both are common in travellers to developing countries. The combination Twinrix vaccine protects against both.
Should I carry a sterile medical kit when travelling?
Yes, particularly for travel to developing countries. A basic kit containing sterile needles, syringes, sutures, and gloves can be presented to medical staff if you need treatment, reducing the risk of hepatitis B and other blood-borne infections from reused equipment. These kits are available from travel clinics and pharmacies in Australia.
Sources & References
Last updated: April 2026