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


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