Hepatitis B transmission
Hepatitis B is blood-borne virus. That means it’s transmitted through blood (including menstrual blood) and sexual fluids such as semen and vaginal fluid.
The hepatitis B virus cannot penetrate unbroken skin and is killed by the digestive juices in the stomach if it is swallowed.
Hepatitis B cannot be transmitted through casual contact such as touching, kissing, hugging, sharing food or if bodily fluids come into contact with intact skin.1
There are three ways hepatitis B can be transmitted:
- Mother living with hepatitis B can pass it onto to her baby during childbirth. This is the most common route globally.
- Unprotected sexual contact. Semen and vaginal fluids.
- Direct blood to blood contact. When blood of a person with hepatitis B enters the blood stream of another person.
Everyone is at risk
Everyone is at risk of contracting hepatitis B. Mother to baby transmission of hepatitis B at birth is the most common way hepatitis B is transmitted globally. Hepatitis B transmission can also happen in various situations, even sometimes out of a person’s control.
To reduce your risk of getting the virus, it’s important to be blood aware.
This means assuming that all blood and bodily fluids potentially contain any blood borne viruses. Taking steps to avoid other people’s blood from coming into contact with yours can help reduce the risk of contracting hepatitis B.
While anyone can contract hepatitis B, there are some situations that can increase your risk.
Mother to baby
The most common way people get hepatitis B is when they are born (known as vertical transmission) to a mother living with hepatitis B. A mother with chronic hepatitis B has a 95% chance of passing the virus onto her baby if there is no intervention to prevent transmission (such as vaccination and administration of immunoglobulin).2 If a mother with hepatitis B passes on the virus to her baby at birth, there is a 90% chance that the baby will go on to develop chronic (long term) hepatitis B.3
Around 30%-65% of people with chronic hepatitis B are unaware they have it until they are screened.4 Testing and monitoring of pregnant women with hepatitis B is an important step to stop the cycle of chronic hepatitis B transmission.
Blood to blood contact
There are several ways blood to blood contact can transmit the hepatitis B virus.
- Mother to child during childbirth
- Sexual contact
- Injecting drug use
- Needlestick injury
- Body art and tattooing
- Beauty salons
Injecting drug use
Sharing injecting equipment carries a risk for hepatitis B transmission. Injecting equipment can include needles, syringes, spoons, swabs, tourniquets, water and filters. When people inject, small amounts of blood may be present on a person’s finger, on a tourniquet, or on a bench top or tabletop. If hepatitis B virus is present in the blood, it can be transmitted to someone else who doesn’t have the virus.
Body art and piercing
Hepatitis B can be transmitted through body art (tattoo) and piercing procedures. However, you reduce the risk to almost nil by visiting a professional studio.5
All professional or registered body art operators in Australia are legally required to follow infection control guidelines which reduces the risk of transmission.
You increase the risk of getting hepatitis B if you get a non-professional (amateur) tattoo or piercing in a juvenile detention centre, prison, or by a backyard operator. The equipment they use is often not clean and has nearly always been used on other people before your turn.
Tattoos, body piercing and other body art, which is done overseas, may also carry a higher risk for contracting hepatitis B, even in a legal premise. This is because infection control procedures may not be as strict as tattoo studios in Australia.
Beauty salons
Some procedures carried out at beauty salons may pose a risk for hepatitis B transmission. These include treatment that involve penetration or damage to the skin, such as waxing, tweezing, electrolysis, microdermabrasion, nail treatments, razor scraping and cosmetic tattooing. However, all registered salons should adhere to infection control guidelines when providing these services.
In Australia, all beauty salons are legally required to follow infection control guidelines. Visiting an amateur salon, or a salon overseas may increase your risk of contracting the virus. Their equipment may not be clean, or they may not follow strict infection control procedures.
Needlestick injury in a health care setting
A needlestick injury is when the skin is accidentally punctured by a used needle. These injuries usually happen in hospitals and health clinics. Overall, the risk of getting hepatitis B from needlestick (or sharps) injury in a health care setting is about 6%-30% from a needle previously used on a person living with hepatitis B.6 This risk depends on several factors, such as the size and type of the needle and the depth of penetration achieved.
It’s recommended health care workers be vaccinated against hepatitis B. They should also follow infection control precautions at all times.
Needlestick injury in a non-health care setting
It’s possible to get a needle stick injury while picking up rubbish or stepping on a used needle in a public place, like a street, park or beach. However, the likelihood of contracting hepatitis B this way is very low. If you do sustain a needle stick injury, ask your doctor about getting tested.
Medical and dental procedures
Australia has very strict infection control guidelines for all medical settings. These are designed to prevent the transmission of blood borne viruses and other diseases, including hepatitis B. Having medical and dental procedures in Australia is generally very safe.
Some other countries may not have the same strict infection guidelines. Undergoing medical or dental treatment overseas, especially in countries where rates of hepatitis B are high, may increase your risk of contracting the virus.
Sharing of razor blades, toothbrushes, and other personal grooming aids
Hepatitis B may be transmitted through sharing items used for everyday hygiene if blood is present. To reduce the risk you should avoid sharing razor blades, toothbrushes (due to the possibility of bleeding gums) and sharp personal grooming aids, even if you can’t see any blood on these items. Consider using different coloured razors or toothbrushes to reduce accidental sharing.
Sexual transmission
Hepatitis B can be transmitted through semen and vaginal fluids, as well as menstrual blood. For hepatitis B transmission to occur bodily fluids of a person living with the virus must get into the blood stream of someone without the virus.
Key Concept:
Sexual transmission of hepatitis B is more likely if:
- Sexual activity leads to skin breakage.
- You have unprotected vaginal or anal sex.
- Other sexually transmissible infections (STIs) are present. STIs can lead to ulcers and breaks in the skin of the genital area, which can increase the risk of contracting hepatitis B.
Practicing safer sex will reduce your risk of hepatitis B transmission.
Further Reading:
For more information on sexual health, you can visit:
Testing other people at risk
Because hepatitis B can be transmitted to others, we encourage all family members to be tested for hepatitis B if one member of the family is diagnosed. This may be a difficult discussion to have in your family. However, you can call Liverline 1800 703 003 for advice and support around disclosure of your hepatitis B status.
