About hepatitis B

Hepatitis B is caused by the hepatitis B virus. If you get infected with this virus, it travels through your blood to your liver, where it causes inflammation.

Hepatitis B isn’t common in Australia because children are routinely immunised against it as part of the National Immunisation Program.

Hepatitis B is more common in other parts of the world, especially in developing countries that don’t have immunisation programs. If you aren’t immunised and travel to these places, you can be at risk of getting hepatitis B if you’re exposed to the blood of someone who’s infected with the virus.

How hepatitis B spreads

Hepatitis B spreads through blood-to-blood contact – that is, when people come into contact with the blood of someone who has the virus.

If women have hepatitis B, they can pass it on their babies during pregnancy, around the time of birth. This is the most common way that children get hepatitis B in Australia.

You can also get hepatitis B if you:

• share needles during drug use
• come into accidental contact with a discarded needle
• get a tattoo or body-piercing with a dirty needle
• share toothbrushes, razors or other things like that
• have sex without using condoms.

Hepatitis B symptoms

Hepatitis B symptoms usually appear a few months after infection with hepatitis B virus.

Children with hepatitis B can have very few obvious symptoms. They might have no symptoms at all, which sometimes makes hepatitis B hard to diagnose.

When there are symptoms, they might come on gradually and include:

• loss of appetite and energy
• stomach pain (especially over the upper right side where the liver is)
• vomiting
• fever
• signs of jaundice, including yellowish skin or eyes
• rash
• dark urine and pale or white poo
• painful or swollen joints.

Medical help: when to get it for children with hepatitis B

You should take your child to the GP if your child has any of the symptoms above or you think your child might have come into contact with the hepatitis B virus.

You should also speak to your GP if you think you might have been exposed to hepatitis B during your pregnancy.

Your GP might refer you to a specialist with experience in treating hepatitis B.

You know your child best. If your child seems unwell, trust your instincts and seek medical attention.

Tests for hepatitis B

If the GP thinks that your child’s symptoms might be caused by hepatitis B, your child will need blood tests to confirm the diagnosis.

Children infected by hepatitis B need to have blood tests at least once a year to check on their infection and help doctors make treatment decisions.

Sometimes children need ultrasounds of their livers.

Treatment for hepatitis B

Some children will recover from the virus within weeks or months. They don’t need treatment.

Other children might develop chronic hepatitis B and will live with the virus in the long term. This can put them at risk of liver scarring, liver failure and liver cancer in the future.

This is why it’s important for children with chronic hepatitis B to have checks on their livers and general health every 6-12 months.

There are some safe and effective anti-viral medicines for chronic hepatitis B. Health professionals might prescribe them for older children and teenagers, especially children with liver damage.

Hepatitis B prevention: immunisation

The best way to avoid hepatitis B is to have your child immunised. As part of the Australian National Immunisation Program (NIP), your child will get free immunisation against hepatitis B at:

• birth
• 6-8 weeks
• 4 months
• 6 months.

Babies who are born very prematurely or have a low birth weight get an additional free hepatitis B vaccine at 12 months.

Hepatitis B immunisations are given by injection, often in combination with immunisation against other diseases.

Hepatitis B prevention during pregnancy and breastfeeding

It’s very important for pregnant women to be tested for hepatitis B.

If a pregnant woman has hepatitis B, she might be given medicine to reduce the chance of passing the virus on to her baby. At birth, the baby might also get a special injection of antibodies against hepatitis B, as well as the standard hepatitis B immunisation.

Women who have hepatitis B can safely breastfeed unless their nipples are cracked or bleeding.

Hepatitis B prevention measures for all children and teenagers

Hepatitis B can also be transmitted through exposure to infected blood.

If your child is accidentally cut or scratched with a used needle, use soap and water to wash your child’s skin where the contact happened. Then see your GP. Your GP might order blood tests and also an extra hepatitis B immunisation. The risk of getting hepatitis B from this kind of contact is very low.

Your child should not share toothbrushes, razors or other items that belong to someone who has hepatitis B, because these things might be contaminated with infected blood.

Hepatitis B prevention measures for teenagers

If your teenage child is sexually active, they can reduce their risk of getting hepatitis B by using condoms during vaginal or anal sex.

You can help reduce your child’s risk by making sure your child has:

• accurate information about safe sexual practices
• access to condoms
• access to reliable advice about sexuality and sexual health from a GP or other health professional.

If your child wants to get a tattoo or body-piercing, you can help them find a safe and professional tattooist or piercer.

If you’re concerned that your child is using intravenous drugs, you could start by talking to your GP, your child’s school counsellor or other school staff for resources and support options.