Hepatitis B

What is hepatitis B?

69ac1e4d4f9f4eb0b067cac6eaef7010_f931 Hepatitis B (HBV) is a virus spread through contact with blood or bodily fluids of an infected person. The infection leads to inflammation of the liver.

Short-term (acute) and long-term (chronic) infection

Acute hepatitis B occurs when a person is infected with the hepatitis B virus for less than six months. Chronic hepatitis B is a long-term infection that lasts more than six months and needs regular monitoring.

The virus causes inflammation of the liver, which affects the way the liver works. The liver is a very important organ that does many tasks essential for life and growth. Hepatitis B causes scarring of the liver and, over many years, can result in cirrhosis, which stops the liver working properly. Liver damage can also lead to liver cancer or liver failure.

Please read our information sheet for more detail about the liver.

How common is hepatitis B?

Hepatitis B is the world’s most common serious liver infection and the leading cause of liver cancer. About 100,000 people in New Zealand have the virus. Every year 250 New Zealanders and over one million people worldwide die from hepatitis B-related liver disease.

How is hepatitis B spread?

It is common in certain parts of the world. People from Asia, the Pacific Islands, Africa, the Middle East, southern Europe or the northern or eastern parts of New Zealand’s North Island should get tested.

Hepatitis B is spread through contact with blood or sexual fluids. It is highly infectious and can survive outside the body for more than seven days, including on playground or unsterile tattooing or medical equipment.

About 99 percent of people with chronic hepatitis B were infected as babies (from their mother during birth) or young children (through contact with other children or a household member with the virus). When young children and babies get infected, they develop chronic infection with the associated life-long risks of cirrhosis, liver failure and liver cancer. When adults are infected, they often become sick with acute hepatitis (jaundice, abdominal pain and vomiting) but usually get rid of the infection.

What tests are required to diagnose hepatitis B?

There are two tests used to diagnose hepatitis B:

  • HBsAg (hepatitis B surface antigen). This test shows whether the virus is present in the blood.
  • Anti-HBc (hepatitis B core antibody). This test shows whether a person has ever been exposed to the hepatitis B virus. The core antibody is detected in patients with current infection and people with previous infection that has resolved.

What are the symptoms of hepatitis B?

Many people with chronic hepatitis B have no symptoms. It is often referred to as the silent epidemic because it’s common for people not to notice any symptoms until 20 or 30 years after infection. Any symptoms that do appear are usually mild and non-specific. The most common symptoms include:

  • Tiredness (fatigue)
  • Joint pain
  • Loss of appetite
  • Nausea
  • Abdominal pain.

Who should I tell?

The Human Rights Act states that you do not have to tell anyone you have hepatitis, but you should take reasonable precautions to prevent the spread of the virus to others.

You may choose to share your diagnosis with particular people for support. It is often best to tell people you trust or people directly affected, such as household members or sexual partners.

Telling healthcare workers such as a doctor or nurse may be beneficial for good health care (e.g. prescribing the most appropriate medications). Health care workers, including dentists, are required to use standard infection control precautions for all situations and procedures that may involve exposure to blood or other bodily fluids, regardless of whether you have hepatitis or not.

Do I need to tell my employer?

People living with hepatitis do not have to tell employers, unless you work in an environment that may put others at risk, such as healthcare. However, disclosure is not mandatory. Discrimination against people with hepatitis in the workplace is illegal. Read more about telling others here.

How to avoid infecting others

Hepatitis B is mainly spread by transfer of blood and other bodily fluids from one person to another.  It is not spread through:

  • touching
  • sneezing
  • coughing
  • using the same toilet
  • kissing
  • not washing hands

To avoid infecting others you should:

  • Cover any open cuts or sores
  • Clean any blood spillage with household bleach (do not put bleach on your skin)
  • Not donate blood
  • Practice safe sex. Use condoms until your partner has evidence of protective immunity
  • Vaccination for sexual contacts and household members (free vaccine is available)
  • Not share piercing, tattooing, drug-injecting or snorting equipment
  • Not share razors, towels, toothbrushes, or any object that may come into contact with blood or sexual fluid.

Is there a hepatitis B vaccination?

Yes, there is a safe and effective vaccine to protect against hepatitis B. The vaccination is made up of three injections over 3-6 months. Since 1987 a vaccination has been available to all babies born in New Zealand. The vaccination is free to everyone under 18 through general practitioners. It is also offered free to household contacts and sexual partners of people infected with hepatitis B. The vaccination is recommended (but not publicly funded) for many other at-risk groups such as health care workers.

What treatment is available for hepatitis B?

Only people with high levels of virus and liver enzymes in their blood need treatment. The medicines control chronic hepatitis B by stopping the virus from multiplying. The treatment is a single tablet once a day. Once you begin treatment you may need to continue it for many years.

Why is it important to be monitored?

You should have regular blood tests every six months to check whether the hepatitis B has become active and whether you need treatment. Blood tests can also detect liver disease. Treatment helps prevent further damage and reverses damage from liver scarring. To help you look after yourself you can enrol in the our national hepatitis B monitoring programme. We will organise your blood tests to help with the health of your liver. You may not experience symptoms from the virus but that doesn’t mean liver damage isn’t occurring. Regular blood tests may detect damage to your liver early and allow for treatment before you feel sick.


© The Hepatitis Foundation of New Zealand 2016