Hepatitis B

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Hepatitis B is a liver disease caused by the hepatitis B virus. Hepatitis B infection can lead to long-term liver disease which, left unmanaged, can result in cirrhosis or liver cancer. In Australia it is the leading cause of primary liver cancer with over 470 hepatitis B related deaths in 2019. About three quarters of the deaths were from hepatitis B related liver cancer and the remaining from hepatitis B related cirrhosis.

Hepatitis B virus is transmitted when blood from a person with the hepatitis B virus enters the bloodstream of a person with no hepatitis B immunity. It is also transmitted via the semen or vaginal fluid of an infected person. The hepatitis B virus can survive outside the body for at least seven days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine.

The most effective protection against hepatitis B is vaccination.

To know if you are immune or if you have a current hepatitis B infection, or which stage your chronic hepatitis B is at, you will need to have a blood test done.

For people unfamiliar with hepatitis B tests, the results might seem complex.Initial tests look for three markers, hepatitis B surface antigens, hepatitis B surface antibodies and hepatitis B core antibodies. Different combinations of results of the these markers indicate different things. See these information sheets — available in English, Chinese and Vietnamese — for simple explanations.

 

Below is a summary of hepatitis B tests from SA Health.

Test What a positive result means
Hepatitis B surface antigen
(HBsAg)
  • Shows that the person has hepatitis B.
  • It can be detected during acute and chronic infection.
Hepatitis B surface antibody
(HBsAb or anti-HBs)
  • Shows that the person has developed immunity to hepatitis B.
  • It can be detected in people who have recovered from acute hepatitis B or been vaccinated against it.
Hepatitis B e antigen
(HBeAg)
  • Shows that hepatitis B virus is multiplying, and that it can be more easily passed on.
Hepatitis B e antibody
(HBeAb or anti-HBe)
  • Shows that the person’s immune system has responded to hepatitis B and in some circumstances that the virus is not actively replicating.
Hepatitis B core antibody
(HBcAb or anti-HBc)
  • Shows that a person has had hepatitis B.
  • Could indicate past or present infection.
  • (If someone has immunity through vaccination they will not test positive.)
Hepatitis B virus DNA (HBV DNA)
  • Measures the amount of hepatitis B virus in the bloodstream and indicates how actively the virus is multiplying.

Currently, the main aim of most hepatitis B treatment is to reduce liver damage by controlling the replication of the virus. This helps to cut down the risk of serious disease, enabling the liver to repair itself. Not everyone with chronic hepatitis B needs treatment all the time. Treatment is started when the virus enters an active phase.

The decision of when to treat and what treatment to use, is complex and needs to be made by a specialist based on individual assessments.

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