|Causative organism||Hepatitis B virus|
|Incubation period||45-180 days (mean 60 days)|
|How far to trace back||
6 months prior to onset of acute symptoms. If unknown, according to risk history. May include extended family members if mother to child (vertical) transmission is likely.
Recent diagnosed chronic hepatitis B infection (6 months and possibly parents/siblings).
|Usual testing method||Serology for hepatitis B (HBsAg – Hepatitis B surface antigen, anti-HBs – Hepatitis B surface antibody, anti-HBc – Hepatitis B core antibody). Positive HBsAg indicates current infection.|
Jaundice, malaise, abdominal pain, dark urine, clay coloured stool
|Likelihood of transmission per act of condomless intercourse||Unknown, but generally transmission via sex is considered high|
|Likelihood of long-term sexual partner being infected||>20%|
|Protective effect of condoms||High|
|Transmission by oral sex||Low|
|Duration of potential infectivity||
In acute hepatitis B infection, two weeks before onset of symptoms and until the patient becomes surface antigen negative.
More than 95% of adults who are immune-competent, and infected with hepatitis B will spontaneously clear the virus.
The majority of those who acquire the infection at birth or as a child will have lifelong chronic hepatitis B infection (where the individual has not been previously tested and has a reactive HBsAg 6 months after the baseline test)
|Important sequelae||Severe, acute hepatitis, chronic liver disease, cirrhosis and liver cancer, vertical transmission to child during or after pregnancy|
|Direct benefit of detection and treatment of contacts||
Post-exposure prophylaxis for non-immune people exposed to a source that is positive for hepatitis B surface antigen (see below)
Detection and management of hepatitis B infection
|Usual management of contacts||
Counselling and testing
Post-exposure prophylaxis consists of Hepatitis B Immunoglobulin (HBIG) and vaccination. These need to be provided as soon as possible after exposure. See Australian Immunisation Handbook for details of dosing.
|Contact tracing priority||
People known to be immune to HBV will need no further testing.
High for sexual contacts, needle-sharing contacts, a newborn child of an infected birth parent
Medium priority for parents and siblings of an adult with chronic hepatitis B infection, close contacts if any risk exposures
Acute viral hepatitis B is notifiable by doctors in all Australian states and territories, and New Zealand
Hepatitis B surface antigen-positive results must be notified by laboratories in NSW
Note: Hepatitis D virus (delta agent) is a deficient virus that is entirely dependent on concurrent hepatitis B infection. Measures to control hepatitis B should control HDV.
ASHM; National Hepatitis B Testing Policy; Conveying Test Results
Hepatitis Australia - Clinical Guidelines
Australian Government Department of Health. Third National Hepatitis B Strategy 2018-2022. 2018. Available at: https://www.health.gov.au/resources/publications/third-national-hepatitis-b-strategy-2018-2022
Page last updated September 2022