Hepatitis B


  • Anyone with a positive hepatitis B surface antigen (HBsAg) needs ongoing monitoring and needs to be considered for treatment. A healthy carrier does not exist.
  • Infection causes acute hepatitis, which may progress to chronic infection.
  • Chronic hepatitis B infection (HBsAg positive) can cause hepatocellular carcinoma even in the absence of liver cirrhosis.
  • Transmission occurs from mother to child (vertical), via parenteral exposure (shared injection equipment), or through sexual or household contact (horizontal).
  • The risk of developing chronic hepatitis B is > 90% if infection acquired at birth or < 5 years and < 5% if infection acquired as an adult.
  • In Australia, routine adolescent immunisation commenced in 1997 and universal infant vaccination commenced in May 2000. Therefore those who were 34 years old or younger in 2020 and who grew up in Australia can generally be assumed to have been vaccinated and do not need testing. However, for certain high-risk population groups it may still be warranted to check their hepatitis B serology (e.g. people with HIV, or people who inject drugs).
  • Elevated prevalence among Aboriginal and Torres Strait Islander people living in remote areas and among some culturally and linguistically diverse populations.
  • Most people living with chronic hepatitis B in Australia were born overseas, particularly in the Asia Pacific region, Europe, Africa and the Middle East.

More information on priority populations for hepatitis B virus (HBV) testing is found at the ASHM Hepatitis B Testing Portal.