What is hepatitis B?

Hepatitis B is a liver infection caused by the hepatitis B virus affecting more than 240 million people worldwide. It can cause both acute (short-term) and chronic (long-term) disease. Chronic hepatitis B can cause scarring of the liver (cirrhosis), liver failure and is the leading cause of liver cancer. Without monitoring and treatment, 1 in 4 people with chronic infection die from liver cancer or liver failure.

The acute infection lasts up to 6 months, with 5-10% of the cases developing into a chronic infection. Being infected at a young age, especially during birth and early childhood, greatly increases the risk of developing chronic hepatitis B:

  • 90% of infants infected at birth develop chronic hepatitis B

  • 50% of children infected before 6 years develop chronic hepatitis B

How is hepatitis B transmitted?

The hepatitis B virus is transmitted from person to person by blood and bodily fluids, for example:

  • At birth (mother to child transmission)

  • Contaminated needles and other drug injection equipment

  • Piercing and tattoo equipment

  • Contaminated medical equipment

  • Direct contact with uncovered wounds

  • Unprotected sex

What are the symptoms?

Chronic hepatitis B is a “silent killer” because many people have no symptoms and do not know they are infected. Some people may show mild symptoms such as:

  • Nausea

  • Yellow skin/eyes (jaundice)

  • Dark urine

  • Fatigue

  • Loss of appetite

However these may not be detectable until the disease has become severe and too late for treatment to help.

Hepatitis B: a global health epidemic

Every year hepatitis B causes over 700,000 deaths. Worldwide 240 million people are infected with chronic hepatitis B.

The highest rates of hepatitis B are seen in low and middle income countries, including sub-Saharan Africa and the Asia Pacific, where there is limited access to health care. In these regions, 5-15% of adults may be chronically infected. Rates above 8% are considered high.

In Australia, 213,000 people are chronically infected with hepatitis B. However, half of Australians with chronic hepatitis B are undiagnosed. Early diagnosis is important to enable people to access treatment, care and monitoring.

Global distribution of hepatitis B. Source: Centers for Disease Control and Prevention, see http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/hepatitis-b (Accessed 4/7/2016)

The good news?

Hepatitis B can be prevented.

There is a safe, cheap and 95% effective vaccine which can prevent hepatitis B and its deadly consequences. It was also the world’s first anti-cancer vaccine. Since its introduction in 1982, over one billion doses have been used worldwide, resulting in a decline in childhood hepatitis B rates in many countries to <1%.

The World Health Assembly passed a resolution in 1992 recommending global vaccination against hepatitis B. Many countries have included a birth-dose hepatitis B vaccine in their national guidelines to prevent mother-child transmission. These steps have helped reduce the massive burden of disease and save millions of lives.

Hepatitis B can be treated.

For people living with chronic hepatitis B, there are also effective oral antiviral medications to treat the infection. Whilst this is not a cure and many people will need to take the medications lifelong, it is very effective at reducing the levels of virus in the body. This helps to prevent the serious consequences of untreated hepatitis B including cirrhosis and liver cancer. Many people around the world are already receiving treatment for hepatitis B, however there are also many for whom medications are unaffordable or difficult to access. Greater efforts must be taken to ensure all people who need life-saving treatment are able to receive it.

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