Hepatitis B
Key Findings
The disease
Hepatitis B is a serious liver infection caused by the hepatitis B virus. Once infected, those with the infection will either get rid of the virus and have no further problems or develop chronic hepatitis B, which is usually infectious for life. Chronic hepatitis B can cause many serious health complications, including cirrhosis (permanent scarring of the liver), liver failure and liver cancer. Approximately 90% of infected children less than 12 months of age will develop chronic infection, compared with 30% of children infected between 1 and 4 years of age and less than 5% of those infected as adults.
Transmission
Contact with a hepatitis B-infected person's blood or bodily fluids (e.g. semen or vaginal secretions) can result in infection. Sharing razors, needles, injecting equipment, toothbrushes and earrings, and having sexual intercourse without using a condom are all examples of how infection can occur. Hepatitis B-positive mothers can infect their newborns when giving birth. Hepatitis B can also be transmitted in medical settings via needlestick injuries or the use of equipment that has not been properly sterilised.
Signs and symptoms
Signs and symptoms of hepatitis B include:
- fever
- nausea and vomiting
- tiredness
- joint pain
- abdominal pain
- loss of appetite
- jaundice (yellowing of the eyeballs and skin)
- pale stools and dark urine.
However, infection can also be present with no symptoms.
Vaccination recommendations and coverage
Under the National Immunisation Program, hepatitis B vaccine is recommended and funded at birth, followed by three more doses of a combination vaccination at:
- 2 months of age
- 4 months of age
- 6 months of age.
Who is most affected?
Hepatitis B is most common in adults who were born before the introduction of the hepatitis B vaccination program for infants in 2000.
How common is it?
There were 612 notifications of acute hepatitis B during the period 2016–2019, with 58 (9.5%) of these reported in Aboriginal and/or Torres Strait Islander people. The highest age-specific notification rates were seen in Aboriginal and/or Torres Strait Islander people aged 25–49 years (3.4 per 100,000 population per year), followed by those aged 50+ years (2.0 per 100,000 population per year) and 15–24 years (1.7 per 100,000 population per year). Rates within these Aboriginal and/or Torres Strait Islander age groups are significantly higher than for other Australians.
- There has been a threefold reduction in hepatitis B notification rates in Aboriginal and/or Torres Strait Islander people of all ages since vaccine introduction.
- Hepatitis B notification rates remain four times higher for Aboriginal and/or Torres Strait Islander people than for other people.
Hospitalisations/deaths
During 2016–2019, there were 320 hospital admissions for acute hepatitis B, of which 29 (9.1%) were Aboriginal and/or Torres Strait Islander people. The hospitalisation rate of Aboriginal and/or Torres Strait Islander people was three times higher than that for other Australians. All Aboriginal and/or Torres Strait Islander admissions were of people aged 5 years and over. Over the 2016–2019 period, there were 56 deaths for which hepatitis B was the underlying cause. 1–5 of these were reported as being in Aboriginal and/or Torres Strait Islander people, all of whom were over the age of 25.
Low rates of hepatitis B in people aged <15 years show the success of the universal infant immunisation program introduced in 2000.