Hepatitis B: It's Family Business


What is hepatitis B?

Hepatitis B is a liver infection caused by the hepatitis B virus. It can lead to liver damage and liver cancer. Many people who have the virus don’t know that they are infected. The most common way hepatitis B is passed on in many countries is from mother to baby at birth.

Hepatitis – the basics.

The word ‘hepatitis’ means inflammation of the liver. The liver is very important for your wellbeing. When the liver is inflamed or damaged, it may not work properly and this can affect your health.

Inflammation of the liver can be caused by alcohol, drugs or viruses. In Australia the most common viruses that can cause hepatitis are the hepatitis A virus, the hepatitis B virus and the hepatitis C virus. These viruses are all different, the only thing they have in common is that they all affect the liver.

Hepatitis A is transmitted (passed on) through contaminated food or water. The body gets rid of the virus by itself after a short period of time. There is a vaccine to prevent hepatitis A.

Hepatitis C is transmitted through blood-to-blood contact and can cause liver damage and liver cancer. Treatment is available for hepatitis C, but there is no vaccine to prevent it.

This brochure contains information about hepatitis B. There is a vaccine to prevent hepatitis B and there are medications for people who already have the disease.

What happens when you get hepatitis B?

Hepatitis B can be acute or chronic. Most adults who get infected with the hepatitis B virus will get rid of the virus (clear it) within 6 months and develop protection against it. Once they clear it, they cannot be infected with the hepatitis B virus again and cannot pass it on to others. This is called acute hepatitis B.

When the infection lasts for more than 6 months, the person has developed chronic hepatitis B. 90% of babies who get hepatitis B will develop chronic infection which can cause liver damage, liver failure (where the liver can’t work properly) and sometimes liver cancer when they are adults.

Age of infection Approximate number of people who will develop chronic hepatitis B as adults
0-1 YEAR 90 out of 100
1-5 YEARS 60 out of 100
ADULTS 5 out of 100

The younger a person is when they get hepatitis B, the higher the risk of developing liver damage and liver cancer as an adult. The majority of people living with chronic hepatitis B in Australia were born overseas and got hepatitis B when they were babies or young children.

Chronic hepatitis B and your health

If you have chronic hepatitis B, you need to see your doctor at least once a year as liver damage can happen at any time. Your doctor will give you the best advice on how to look after yourself and take care of your liver. The doctor will also tell you if you need to take medications and will refer you to a liver specialist if necessary. Most people with chronic hepatitis B live a healthy life and never need to take medication for their hepatitis B.

To help your liver:

  • drink less alcohol or none at all
  • eat a balanced healthy diet, avoiding too much fat
  • maintain a healthy body weight
  • stop or reduce smoking
  • exercise regularly
  • manage your stress, getting support and resting as much as you need
  • get vaccinated for hepatitis A to protect you from getting another hepatitis virus, which can cause more severe liver disease.

No such thing as a ‘healthy carrier’

Chronic hepatitis B is a complex disease that changes over time, with some periods when the liver is not being damaged. In the past, people going through these periods were sometimes called ‘healthy carriers’. However, the disease can change without you knowing and you may be at risk of liver damage. We now know there is no such thing as a ‘healthy carrier’. The only way to know what chronic hepatitis B is doing to your liver is by having regular liver checks. Even if you were told you were a ‘healthy carrier’ in the past, you still need to see your doctor for a check-up at least once a year.

How do you get hepatitis B?

Hepatitis B is found in body fluids such as blood, semen and vaginal fluids of an infected person. Hepatitis B transmission can only occur when body fluids from an infected person enter another person’s body. Even amounts of fluid too small to be seen can transmit the virus.

The younger a person is when they get hepatitis B, the higher the risk of developing chronic hepatitis B as an adult. The most common ways this happens are:

  • At birth, from an infected mother to her baby, especially in developing countries.
  • In childhood, from person to person through sores or cuts that are not covered.

Most adults who get hepatitis B, clear the virus. The most common ways adults get the virus are:

  • By having sex without a condom with a person who has hepatitis B.
  • By sharing drug injecting equipment.

Hepatitis B can also be passed on:

  • By sharing personal items such as razors, toothbrushes or other items that may carry blood
  • Through injections, medical and dental procedures in countries where equipment is not sterilised (cleaned) properly. In Australia, these are safe.
  • Through blood transfusions in countries where blood is not checked for hepatitis B. In Australia these are safe.
  • Through traditional practices that may involve blood, e.g. acupuncture.
  • Using tattooing equipment that has not been sterilised properly. This includes cosmetic tattooing.

You cannot get hepatitis B from:

  • coughing
  • hugging
  • insect bites
  • sharing bathroom and toilet facilities
  • sharing cooking and eating utensils
  • swimming pools.

Breastfeeding is safe, especially if the baby has been vaccinated against hepatitis B.

How common is hepatitis B around the world?

There are more than 350 million people with chronic hepatitis B around the world, causing up to 1 million deaths each year. In many communities, the most common way that hepatitis B is transmitted is from mother to baby at birth.

Distribution of hepatitis B around the world

Source: WHO, 2001

In Australia, most people with chronic hepatitis B were born in countries where hepatitis B is very common.

What are the symptoms?

Most people with chronic hepatitis B will not have any specific symptoms and many don’t know they have the virus. However, even when there aren’t any symptoms, the virus can be damaging the liver.

Symptoms can come and go, and may be similar to other illnesses. Possible symptoms of chronic hepatitis B include:

  • joint aches and pains
  • loss of appetite
  • nausea (feeling like you want to vomit)
  • pain in the liver (upper, right side of abdomen)
  • tiredness, depression and irritability
  • vomiting.

The only way to know if you have chronic hepatitis B is by getting the correct blood tests.

Testing for hepatitis B

Not all blood tests will show if you have hepatitis B. Your doctor needs to do specific blood tests to find out if you have it. The tests will show if you have chronic hepatitis B or if you have developed protection against the hepatitis B virus. Ask your doctor what tests you need to find out if you have hepatitis B. The health checks you need to migrate to Australia usually do not include a test for hepatitis B.

If you have chronic hepatitis B, your doctor may order more tests to see if there has been damage to your liver and if you need to take medications. Your doctor can explain each test and what it’s for.

You should have a test for hepatitis B if you:

  • Were born or have lived in countries where hepatitis B is common or in countries where there are no free hepatitis B vaccines for babies and children.
  • Have parents or a family member with hepatitis B, liver disease or liver cancer.
  • Ever had a sexual partner with hepatitis B, or live with someone that has chronic hepatitis B.
  • Ever had a blood transfusion, a medical or a dental procedure in a developing country.
  • Have taken part in cultural practices that involve blood, such as tattooing, etc.

Are there any medications that can help?

Whilst hepatitis B cannot be cured, there are medications that can control the virus. They can reduce damage to your liver and reduce the risk of liver cancer. They also help the liver repair itself. Your doctor will tell you if you need to take medication. That’s why it’s important to see your doctor regularly.

If you need to take medication, your doctor will refer you to a liver specialist. The specialist will explain what medications are available and which one is best for you. You will need to see your specialist regularly once you start taking medications. It is very important to keep taking them regularly once you start. If you have problems with the medications, don’t stop taking them; speak to your doctor first.

Tell your doctor and specialist if you take any natural medicines such as herbs or traditional remedies, as some of them can affect your liver or stop your medications from working properly. They can advise you on what herbs or traditional medicines you should avoid.

How can we stop the spread of hepatitis B?

Vaccination is the best way for your family and those close to you to be protected against hepatitis B.

In Australia, all mothers are offered free vaccination for their babies when they are born. To be fully protected, the baby will need other doses in the first 12 months. The vaccine is safe and effective.

Free vaccination is also available for children and adolescents, as well as family and people in close contact with someone who has hepatitis B. Ask your doctor for more information.

Other things we can all do to stop the spread of hepatitis B:

  • Avoid blood-to-blood contact: do not share razors, toothbrushes and other personal items.
  • Cover any open wounds and clean any blood spills with bleach. Do not allow other people to touch your wounds or blood unless they are wearing gloves.
  • Throw away personal items such as tissues, sanitary pads, tampons and bandages in a sealed plastic bag.
  • Use a condom and lubricant when you have sex.
  • Do not share needles or any equipment to inject drugs.

Who do you have to tell?

This is a common question that is difficult to answer because everyone has different needs and relationships. Talking to people who can understand and support you can be helpful. Take your time to decide who you feel you can trust.

Whilst you don’t have to tell everyone that you have hepatitis B, you need to prevent passing it on to others. It’s important to tell the people who live in your house and your sexual partners, so that they can be tested and vaccinated, but you don’t have to tell anyone else.

Telling health care workers, such as your dentist or other doctors, can help them give you the best medical care, but it is your choice. Health workers involved in your care have a responsibility to protect your privacy and keep your information confidential. They cannot discriminate against you in any way.

There are some cases in NSW where the law says you have to let people know that you have chronic hepatitis B.

These include if:

  • your insurance company requires information about infections and illnesses
  • you work for or want to join the Australian Defence Force
  • you want to donate blood or semen

If you are not sure who to tell or how to tell them, talk to the services listed here for advice.

Information and support

Your doctor can answer any questions you may have about hepatitis B, or you can also contact:

  • Multicultural HIV and Hepatitis Service
  • For information about hepatitis in other languages
  • www.mhahs.org.au
  • HALC
  • For questions related to discrimination or other legal issues related to hepatitis B.
  • Ph: 02 9206 2060
  • Freecall: 1800 063 060
  • www.halc.org.au
  • Translating and Interpreting Service (TIS)
  • Ph: 131 450
  • To call any of the services listed and talk to someone in your community language, call the Translating and Interpreting Service (TIS) for the cost of a local call. When the interpreter is on the line, ask him/her to phone the service you want to speak to.

Health care interpreters
Hepatitis B can be complex and difficult to understand. Hospitals have health care interpreters who can interpret everything your doctor says and ask your doctor any questions you may have. When you make an appointment, tell the receptionist you need an interpreter.