Informing your patient
- Provide contact details of support services and relevant material.
- Use a professional interpreter if required. Call Translating and Interpreting Service (TIS) 13 14 50.
- Fact sheets for patients (Healthy WA)
Reduce transmission
Alcohol - a modifiable risk factor for disease progression
Refer to alcohol and drug services as necessary
Immunisation
People with hepatitis B should be offered HAV vaccination, if not immune. See Guidelines for the Provision of Hepatitis A and B Vaccine to Adults in Western Australia at Risk of Acquiring these Infections by Sexual Transmission (PDF 248KB).
Psychological support and counselling
For parents and their family/partners, telephone support, education and support groups are available through Hepatitis WA (external site)
Vaccination
Hepatitis B vaccination is part of the WA childhood immunisation schedule.
The
National Health and Medical Research Council's (NHMRC) Immunisation Handbook (external site) recommends hepatitis B vaccination for adults in the following groups:
- household or other close (household like) contacts of people with hepatitis B
- sexual contacts of people with hepatitis B
- men who have sex with men
- people who inject drugs
- sex industry workers
- individuals with chronic liver disease and/or hepatitis C
- haemodialysis patients
- HIV positive people and other immunocompromised people
- inmates of correctional facilities
- people at occupational risk e.g. healthcare workers, ambulance personnel, dentists, police, staff of correctional facilities, embalmers, tattooists and body-piercers
- migrants from hepatitis B endemic countries
- Aboriginal and Torres Strait Islander people.
Serological testing for evidence of past (or current) hepatitis B infection prior to vaccination may be warranted for certain older children, adolescents and adults, especially those at increased risk of acquiring hepatitis B infection, e.g. people who inject drugs, sex industry workers, immunocompromised people, and those living in communities with higher prevalence of HBV, including migrant communities and Aboriginal and Torres Strait Islander people. Serological testing allows people with HBV infection to be identified which facilitates clinical and public health management to prevent liver damage and onward transmission, respectively.
Standard regimes for vaccination include:
- 0, 1 and 6 months
- 0, 1, 2 and 12 months
- 0, 7, 21 days and 12 months for rapid vaccination of those at highest risk.
Vaccination should be administered into the deltoid muscle.
If doses are missed the course does not need to be restarted, but all doses should be completed.
Serological testing following hepatitis B vaccination
Post-vaccination testing for Anti-HBs antibody and HBsAg levels is recommended:
- 3 to 12 months after completing the primary vaccine course in infants born to mothers with chronic hepatitis B infection.
- 4 to 8 weeks after completion of the primary course for
- those at significant occupational risk (e.g. healthcare workers whose work involves frequent exposure to human tissue, blood or body fluids)
- those at risk of severe or complicated HBV disease (e.g. persons who are immunocompromised, and persons with pre-existing liver disease not related to hepatitis B)
- sexual partners and household, or other close household-like, contacts of persons who are infected with hepatitis B
- those in whom a poor response to hepatitis B vaccination may occur (e.g. haemodialysis patients, persons with bleeding disorders vaccinated via the SC route).
Post-vaccination serology is NOT recommended for other groups
A single booster dose (4th dose) of vaccine can be given to confirm non-responder status. Those who are still non-responders after being given the booster/4th dose should have 2 further doses of hepatitis B vaccine at monthly intervals, and be re-tested for anti-HBs levels at least 4 weeks after the last dose.
Work
People with chronic HBV who are health care workers may perform exposure prone procedures (EPPs) if they comply with the Australian National Guidelines for the Management of Healthcare Workers Living with Blood Borne Viruses and Healthcare Workers who Perform Exposure Prone Procedures at Risk of Exposure to Blood Borne Viruses (external site).