| 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. |
| Common symptoms |
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 |
| Notification |
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 |
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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.
References 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 |
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Page last updated September 2022