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Transmission

Hepatitis B is a blood-borne and a sexually transmitted infection.

Hepatitis B is spread through the blood or sexual fluids (vaginal fluids or semen) of an infected person entering the blood stream of a non-infected person. It is also transmitted from mother to baby during birth.

The hepatitis B virus cannot penetrate unbroken skin and is killed by the digestive juices in the stomach if it is swallowed.

Mother to baby

There is a 95% chance that a mother with chronic hepatitis B will pass it on to her baby, if no steps are taken by the medical staff to prevent transmission. 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.

Diagnosis and monitoring of pregnant women with hepatitis B is an important step in stopping the cycle of chronic hepatitis B. All pregnant mothers in Australia should be tested for chronic hepatitis B infection. Babies born to hepatitis B positive mothers can be given vaccination and hepatitis B immunoglobulin at birth, which reduces the risk of hepatitis B transmission to only 5%. Mothers with very high viral loads can also be treated during pregnancy to prevent transmission.

It is safe to breastfeed if you have hepatitis B. Hepatitis B is not transmitted through breast milk. Hepatitis B may be transmitted if you have cracked or bleeding nipples, however if your baby has been vaccinated they are protected from the low risk of transmission this way. If your baby hasn’t been vaccinated then you just need to express and dispose of milk while your nipples are cracked and bleeding, and recommence breast feeding when your nipples are healed.

Sexual transmission

Hepatitis B is transmitted through semen and vaginal fluids. The sexual fluids of an infected person need to get into the blood stream of a non-infected person for transmission to occur. Sexual transmission is more likely if the sexual act leads to skin breakage or other sexually transmissible infections (STIs) are present. Sexually Transmitted Infections (STIs) can lead to ulcers and breaks in the skin of the genital area, which can increase the risk of contracting hepatitis B.

Practicing safe sex - using condoms, lube, gloves, and either not sharing share sex toys or making sure they are thoroughly cleaned and disinfected between users and that condoms (including femidoms) are used on them. For more information on sexual health, you can visit:

  1. Family Planning Victoria
  2. Melbourne Sexual Health Centre

Injecting drug use

Injecting equipment includes needles, syringes, spoons, swabs, tourniquets, water and filters. In situations where people are injecting, small amounts of blood may be present on a person’s finger, on a tourniquet, or on a bench top or tabletop, and transmission may occur even if people do not share or re-use needles.

Body art and piercing

All body art operators are legally required to follow infection control guidelines. Body art and piercing procedures  should always carried out under sterile conditions and although single-use needles are now common, dye and dye tubs (inkpots) may be re-used for multiple customers. If you get a non-professional tattoo or piercing in a juvenile detention centre, prison, or by a backyard operator your increase you risk of being infected with hepatitis B. 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, even in a legal premise, may carry a higher risk of blood borne virus transmission because infection control procedures may not be as strict as tattoo parlours in Australia.

Needle Stick injury in a health care setting

These occur mainly in occupational settings such as hospitals and clinics, where handling bloody items may also present a risk. Overall the risk of acquiring hepatitis B from needle-stick (or sharps) injury in a health care setting is around 30%. This risk depends on a number of factors, such as the size of the needle and the depth of penetration achieved. Health care and custodial workers are advised to be vaccinated against hepatitis B and take infection control precautions at all times.  

Needle-stick injury in a non-health care setting

Experiencing a needle stick injury while picking up rubbish or stepping on a used needle in a public place, such as a street, a park or a beach, is regarded as a very low risk source of transmission of hepatitis B.

Medical and dental procedures

Infection control guidelines, designed to prevent the transmission of blood borne viruses and other diseases, are strictly adhered to in medical settings in Australia. In some other countries a lack of resources, inadequate infrastructure, a lack of training, or a combination of these factors can create circumstances in which reducing the risk of transmitting diseases is not always possible. Undergoing medical or dental treatment in some countries, especially those countries where rates of hepatitis B are high, may carry with it the possibility of acquiring hepatitis B.

Sharing of razor blades, toothbrushes, and other personal grooming aids

Items used for everyday hygiene may present a possible transmission risk if blood is present. To minimise the risk of transmission within the home, it is suggested that people do not share razor blades, toothbrushes (due to the possibility of bleeding gums) and sharp personal grooming aids.

When wiping up blood spills, it is advisable to wear gloves and use paper towels and lukewarm soapy water (bleach can also be used to disinfect the area).  

Testing other people at risk

Hepatitis B is transmitted from mother to baby (see above). Because of the high risk of mother to baby transmission, and the high risk of the hepatitis B becoming chronic, we encourage all family members (especially siblings and mothers) to also be tested for hepatitis B when one member of the family is diagnosed. This may be a difficult discussion to have in your family, call the Hepatitis Infoline for advice and support around disclosure of your hepatitis B status.

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