Serological Testing After Hepatitis B Vaccination
It is recommended that levels of hepatitis B surface antigen in infants born to mothers with chronic hepatitis B are measured 312 months after they complete the infant vaccine course. Do not test the infant before 9 months of age, to avoid detecting anti-HBs
Post-vaccination serological testing is recommended 48 weeks after completing the vaccine course for:
- people at significant occupational risk, such as healthcare workers whose work involves frequent exposure to human tissue, blood or body fluids
- people at risk of severe or complicated hepatitis B, such as people who are immunocompromised and people with pre-existing liver disease not related to hepatitis B
- people who may respond poorly to hepatitis B vaccination, such as haemodialysis patients and people with bleeding disorders who received the vaccine subcutaneously
- close contacts of people who are infected with hepatitis B virus, including sexual partners, household contacts and household-like contacts22
If serological testing 48 weeks after the vaccine course shows levels of antibody to hepatitis B surface antigen of < 10 mIU per mL, check the person for acute or chronic hepatitis B virus infection by testing for serological markers, including antibodies to anti-HBs and hepatitis B core antigen.
After the booster dose, check for anti-HBs
A non-responder is a person who:
Burden Of Chronic Hepatitis B In Australia
Chronic infection and its sequelae, including cirrhosis and hepatocellular carcinoma, contribute to most of the hepatitis B disease burden in Australia. The burden from chronic disease has been increasing with the increasing number of immigrants from regions of high hepatitis B prevalence.62
First-generation immigrants from countries of high hepatitis B endemicity usually retain the prevalence of chronic hepatitis B virus infection of the country they are from. Migrants born in Asian, Pacific islands, North African, Middle Eastern and Mediterranean countries have a significantly higher prevalence of chronic hepatitis B virus infection than the Australian-born population.62
Other population groups with higher prevalence of hepatitis B virus infection include:63,64
- Aboriginal and Torres Strait Islander people
- people with HIV
- people who injected drugs between 1980 and 1990
- household contacts of someone diagnosed with hepatitis between 1980 and 1990
Notification of chronic hepatitis B virus infection depends on hepatitis B testing and reporting. Many people with chronic hepatitis B virus infection remain undiagnosed. Mathematical modelling suggests that, in Australia in 2015:64
- about 230,000 people were living with hepatitis B virus infection
- about 419 deaths were due to hepatitis B virus infection
Treatment For Chronic Hbv Infection
For chronic HBV infection, antiviral medications are available.
This is not a cure for chronic HBV. However, it can stop the virus from replicating and prevent its progression into advanced liver disease.
A person with a chronic HBV infection can develop cirrhosis or liver cancer rapidly and without warning. If a person does not have access to adequate treatment or facilities, liver cancer can be fatal within months of diagnosis.
People with a chronic HBV infection require ongoing medical evaluation and an ultrasound of the liver
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If I Have Hepatitis How Can I Avoid Giving It To Someone Else
For hepatitis A, one of the best things you can do is wash your hands a lot. That will keep the virus out of food and drinks.
If you have hepatitis B and C, you need to find ways to keep others from making contact with your blood. Follow these tips:
- Cover your cuts or blisters.
- Carefully throw away used bandages, tissues, tampons, and sanitary napkins.
- Don’t share your razor, nail clippers, or toothbrush.
- If your blood gets on objects, clean them with household bleach and water.
- Don’t breastfeed if your nipples are cracked or bleeding.
- Don’t donate blood, organs, or sperm.
- If you inject drugs, don’t share needles or other equipment.
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Complications Of Hepatitis B
A small proportion of people who become infected with the hepatitis B virus develop a long-term hepatitis B infection. They may have the virus in their bloodstream for most of their life without realising they are infected.
People with chronic hepatitis B infection may not notice any health problems until they develop liver problems such as liver disease or liver cancer later in life. Treatment for hepatitis B is essential because it is not possible to be a healthy carrier of the hepatitis B virus. Chronic hepatitis B infection occurs more commonly in some communities, including:
- Aboriginal and Torres Strait Islander communities.
- In people from parts of the world where hepatitis B is more common, such as:
- North-East Asia
- Sub-Saharan Africa.
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Undercooked And Raw Shellfish
Shellfish are animals that filter the water from their surroundings. Because of this, they can become contaminated with hepatitis A virus if they are grown in polluted waters. To be safe, cook shellfish thoroughly before eating it. Undercooked shellfish like oysters, mussels, and clams may harbor and transmit hepatitis A. You may prefer the taste of raw oysters, but cooked shellfish really is safer. Protect your health and skip the raw oyster bar.
How You Can Catch Hepatitis B
You can get hepatitis B through the blood and other body fluids from an infected person. It’s primarily a sexually transmitted disease, but you can also pick it up through used needles, and through body/ear piercing or tattooing with dirty equipment. An infected mother can pass it to her child at birth. Health care and emergency service workers can get it from needle stick injuries and blood splashes in the eyes, nose, mouth or on broken skin. You can’t get hepatitis B from someone coughing, or from hugging or using the same dishes.
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Testing Treating And Reducing Risk Of Hepatitis
If you think youre at risk for hepatitis infection, talk to your healthcare provider about getting tested. A blood test is usually done to see if you have been exposed to the virus. Women who are pregnant or trying to become pregnant should get tested for hepatitis.
Get treated for hepatitis infection
There are treatments for hepatitis. Treating long-lasting hepatitis B or C infection can reduce the amount of the virus in a person, which may lower the risk of liver cancer.
How To Get Vaccinated Against Hepatitis B
All babies in the UK born on or after 1 August 2017 are given 3 doses of hepatitis B-containing vaccine as part of the NHS routine vaccination schedule.
These doses are given at 8, 12 and 16 weeks of age.
Babies at high risk of developing hepatitis B infection from infected mothers are given extra doses of the hepatitis B vaccine at birth, 4 weeks and 1 year of age.
If you think you’re at risk and need the hepatitis B vaccine, ask your GP to vaccinate you, or visit any sexual health or genitourinary medicine clinic.
If your job places you at risk of hepatitis B infection, it’s your employer’s responsibility to arrange vaccination for you, rather than your GP. Contact your occupational health department.
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Interchangeability Of Hepatitis B Vaccines
The Engerix-B and H-B-Vax II vaccines are manufactured by different processes, and the hepatitis B surface antigen content of an equivalent dose of these vaccines is different. Switching vaccine brands is not recommended.
If the brand of vaccine used for previous doses is not known, use another age-appropriate equivalent dose brand. See:
For example, a study in healthy neonates showed comparable high levels of immunogenicity between 2 different mixed regimens that used 2 monovalent hepatitis B vaccines from different manufacturers.33
The Abcs Of Hepatitis B And C
Hepatitis is an infection or inflammation of the liver. It is most commonly caused by a viral infection. There are 6 types of hepatitis viruses types A, B, C, D, E and G.
Two types, hepatitis B and hepatitis C, are linked to cancer.
Hepatitis B is the most common type of hepatitis virus. It is very infectious and is spread mainly by being exposed to infected blood or other bodily fluids . HBV is more likely to cause symptoms than hepatitis C.
HBV infection can cause flu-like symptoms and yellowing of the skin and whites of the eyes . Most people recover completely from HBV infection within a few months and develop lifelong protection against it. Only about 10% of people have an infection that lasts a long time.
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How Do You Catch Hepatitis B
Hepatitis B is passed through sexual fluids and blood. If you havent been vaccinated, you can catch Hepatitis B by having oral, vaginal or anal sex with someone who has it. Small amounts of blood on a shared toothbrush, razor, or non-sterile needle can pass it too. Hepatitis B is also commonly passed on during birth, from the infected pregnant person to their baby. Remember, you dont get Hepatitis B by touching, hugging, kissing, or sharing food with someone who has it.
Always use a condom and never share needles
Most young people in Australia have been vaccinated for Hepatitis B, which means youre protected from getting the infection. If youre not sure if youve been vaccinated, talk to your doctor about it. You can get the vaccine now if you havent had it before.
What Are The Risk Factors For Getting Hepatitis B
Due to the way that hepatitis B spreads, people most at risk for getting infected include:
- Children whose mothers have been infected with hepatitis B.
- Children who have been adopted from countries with high rates of hepatitis B infection.
- People who have unprotected sex and/or have been diagnosed with a sexually transmitted infection.
- People who live with or work in an institutional setting, such as prisons or group homes.
- Healthcare providers and first responders.
- People who share needles or syringes.
- People who live in close quarters with a person with chronic hepatitis B infection.
- People who are on dialysis.
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Can Hepatitis B Be Prevented Or Avoided
The best way to prevent hepatitis B is to always have protected sex and, if you use intravenous drugs, avoid sharing needles.
A vaccine is available to prevent hepatitis B. It is now routinely given in the first year of life to all newborn infants. It is safe and requires 3 shots over a 6-month period. This vaccine should be given to people who are at high risk for this illness, such as healthcare workers, all children, people who travel to areas where the infection is widespread, drug users, and those who have multiple sex partners.
What Are The Signs & Symptoms Of Hbv Infection
HBV can cause a wide range of symptoms, from a mild illness and general feeling of being unwell to more serious chronic liver disease that can lead to liver cancer.
Someone with hepatitis B may have symptoms similar to those caused by other viral infections, like the flu. The person might:
- be extra tired
- feel like throwing up or actually throw up
- not feel like eating
- have a mild fever
HBV also can cause darker than usual pee, jaundice , and belly pain.
People exposed to hepatitis B may start to have symptoms from 1 to 6 months later. Symptoms can last for weeks to months.
In some people, hepatitis B causes few or no symptoms. But even someone who doesn’t have any symptoms can still spread the disease to others.
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Living With Hepatitis B
If you have hepatitis, you should:
- avoid having unprotected sex, including anal and oral sex, unless you’re sure your partner has been vaccinated against hepatitis B
- avoid sharing needles used to inject drugs with other people
- take precautions to avoid the spread of infection, such as not sharing toothbrushes or razors with other people
- eat a generally healthy, balanced diet there’s no special diet for people with hepatitis B
- avoid drinking alcohol this can increase your risk of developing serious liver problems
- speak to your doctor if you’re thinking of having a baby
People with hepatitis B can usually have a healthy pregnancy, but it’s a good idea to discuss your plans with a doctor first as you may need extra care and your medications may need to be changed.
There’s a risk of pregnant women with hepatitis B passing the infection on to their child around the time of the birth, but this risk can be reduced by ensuring the baby is vaccinated shortly after they’re born.
Page last reviewed: 30 January 2019 Next review due: 30 January 2022
How Is Hepatitis B Transmitted
Hepatitis B is spread in several distinct ways: sexual contact sharing needles, syringes, or other drug-injection equipment or from mother-to-child at birth.
In the United States, in 2018, injection drug use was the most common risk factor reported among people with an acute HBV infection, followed by having multiple sex partners. Less commonly reported risk factors included accidental needle sticks, surgery, transfusions, and household contact with a person with HBV infection. In the United States, healthcare-related transmission of HBV is rare.
Mother-to-child transmission of HBV is especially concerning, because it is preventable. An estimated 25,000 infants are born to mothers diagnosed with HBV each year in the United States, and approximately 1,000 mothers transmit HBV to their infants. Without appropriate medical care and vaccinations, 90% of HBV-infected newborns will develop chronic infection, remaining infected throughout their lives. Up to 25% of people infected at birth will die prematurely of HBV-related causes. For this reason, the standard of care for pregnant women includes an HBV test during each pregnancy so that the appropriate steps can be taken to prevent HBV-positive mothers from transmitting the disease to her infant.
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Are Hepatitis B Virus Infections Easily Avoided
Large quantities of hepatitis B virus are present in the blood of people with hepatitis B in fact, as many as one billion infectious viruses can be found in a milliliter of blood from an infected individual. Therefore, hepatitis B virus is transmitted in the blood of infected individuals during activities that could result in exposure to blood, such as intravenous drug use, tattooing, or sex with people who are infected. However, it is also possible to catch hepatitis B virus through more casual contact, such as sharing washcloths, toothbrushes or razors. In each of these cases, unseen amounts of blood can contain enough viral particles to cause infection. In addition, because many people who are infected don’t know that they are infected, it is very hard to avoid the chance of getting infected with hepatitis B virus.
Emergency Hepatitis B Vaccination
If you have been exposed to the hepatitis B virus and have not been vaccinated before, you should get immediate medical advice, as you may benefit from having the hepatitis B vaccine.
In some situations, you may also need to have an injection of antibodies, called specific hepatitis B immunoglobulin , along with the hepatitis B vaccine.
HBIG should ideally be given within 48 hours, but you can still have it up to a week after exposure.
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How Does A Person Get Hepatitis
A person can get hepatitis A through the following sources:
- Food or water contaminated with the fecal matter of an infected person
- Sexual contact
A person can get hepatitis B in many ways, which include:
- Having sexual contact with an infected person
- Sharing needles
- Being in direct contact with an infected persons blood
- Transferred from mother to the fetus
- Getting an infected needle prick
- Being in contact with an infected persons body fluid
A person can get hepatitis C through:
- Sharing infected needles
- Being in direct contact with an infected persons blood
- Getting an infected needle prick
- Having sexual contact with an infected person
Hepatitis D can be spread through:
- Transferred from mother to the fetus
- Being in contact with the infected fluid or blood
- A person can get hepatitis D only if they are infected previously with hepatitis B.
Hepatitis E mainly infects people who eat or drink food or water contaminated with the virus. Under-cooked foods can also spread hepatitis E. It is more dangerous in pregnant women.
Who Should Get The Hepatitis B Vaccine
All newborn babies should get vaccinated. You should also get the shot if you:
- Come in contact with infected blood or body fluids of friends or family members
- Use needles to take recreational drugs
- Have sex with more than one person
- Are a health care worker
- Work in a day-care center, school, or jail
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What Can Be Done At Home
- Be careful to protect your family and sexual partners from the virus.
- Abstain from all alcohol intake if blood samples show that the disease is active.
- Refrain from drinking alcohol daily if you have chronic hepatitis B.
- If you have chronic hepatitis, you should be reviewed regularly in a specialist clinic because there are several treatment options
- Eat a healthy, well-balanced diet.
Babies And Hepatitis B Vaccination
Pregnant women have a routine blood test for hepatitis B as part of their antenatal care.
Babies born to mothers infected with hepatitis B need to be given a dose of the hepatitis B vaccine within 24 hours of their birth, followed by further doses at 4, 8, 12 and 16 weeks of age, plus a final dose when they’re 1 year old.
Babies of mothers identified by the blood test as particularly infectious might also be given an injection of HBIG at birth on top of the hepatitis B vaccination to give them rapid protection against infection.
All babies born to mothers infected with hepatitis B should be tested at 1 year of age to check if they have become infected with the virus.
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