Who should be tested for hepatitis B in Australia?

Australian guidelines recommend hepatitis B testing for people born in regions where the virus is endemic — this includes Southeast Asia, sub-Saharan Africa, the Pacific Islands, and parts of Eastern Europe and the Middle East. Testing is also recommended for people who inject drugs, people with a known exposure history (sexual contact with someone with hepatitis B, needle-stick injury), and people with household or close contact with someone who has chronic hepatitis B. The test involves a blood draw that checks for hepatitis B surface antigen, surface antibody, and core antibody — together these tell you whether you are currently infected, immune from vaccination, immune from past infection, or susceptible. Ask your GP at your next visit if you are unsure whether you've been tested.

What treatment is available for chronic hepatitis B in Australia?

Effective antiviral medications are available through the Pharmaceutical Benefits Scheme (PBS) for people with chronic hepatitis B who meet treatment criteria. The main agents used are entecavir and tenofovir — both taken as a daily tablet. These medications suppress the hepatitis B virus, reduce liver inflammation, and significantly reduce the risk of developing cirrhosis and liver cancer. Treatment does not cure hepatitis B in most cases, but it controls the infection long-term. Not everyone with chronic hepatitis B requires immediate antiviral treatment — your GP or a gastroenterologist or infectious diseases specialist will assess your liver function, viral load, and other factors to determine the right approach. Regular monitoring is important for everyone with chronic hepatitis B, whether on treatment or not.

Hepatitis B elimination: Australia needs 90% diagnosed — we're at 67%

What just happened

The Doherty Institute’s WHO Collaborating Centre for Viral Hepatitis released a national surveillance report on 16 June 2026 tracking Australia’s progress toward WHO’s 2030 hepatitis B elimination targets.

The headline: Australia is not on track.

The 2030 goal was to diagnose 90% of people living with chronic hepatitis B. Current diagnosis rates sit at 67.4%. At the present rate of improvement, Australia will not reach 90% until after 2050 — two decades late on a decade-old commitment.

The both-and

What the data shows

Hepatitis B is a viral infection transmitted through blood-to-blood contact and sexual contact. Chronic hepatitis B — infection persisting longer than six months — is one of the leading global causes of liver cirrhosis and hepatocellular carcinoma (liver cancer). In Australia it disproportionately affects people born in regions where the virus is endemic: Southeast Asia, the Pacific Islands, sub-Saharan Africa, and parts of Europe. These are communities where hepatitis B was commonly transmitted at birth or in early childhood before widespread vaccination became available in those countries.

The National Surveillance for Hepatitis B Indicators Project 2024 lays out the numbers:

67.4% of people with chronic hepatitis B in Australia are diagnosed — well short of the 90% target
Only 12.7% of those with chronic hepatitis B receive antiviral treatment — less than half of those who are eligible
Fewer than 30% of those diagnosed are in ongoing recommended clinical care
Hepatitis B-related deaths have increased by nearly 15% since 2015
Australia needs 119,000 more people engaged in ongoing care, and 27,000 more started on antiviral treatment, to meet the 2030 targets

Why this is preventable — and what’s getting in the way

The particular tragedy here is that effective treatment exists. Antiviral medications are PBS-listed, inexpensive, and highly effective at suppressing the virus, preventing liver disease progression, and reducing the risk of liver cancer. This is not a situation where the science is insufficient. The tools are available. The gap is in reaching and engaging people.

The Fourth National Hepatitis B Strategy 2025–2030, released alongside this surveillance report, identifies three priorities:

Community-led approaches. People from communities with high hepatitis B prevalence are more likely to engage with testing and care through trusted community organisations, bilingual health workers, and peer navigators than through cold referrals from unfamiliar clinical settings. Nafisa Yussf of Hepatitis B Voices Australia was quoted directly: “community-led, peer-driven solutions that are trusted, culturally safe” are what is needed.

Better data systems. Australia cannot measure what it does not count. Stronger national monitoring is foundational to understanding where the gaps are and whether interventions are working. The current surveillance project is a step forward; the strategy calls for it to be embedded and expanded.

General practice engagement. GPs are the first point of contact for most Australians with chronic hepatitis B. The quality of that engagement — whether a GP screens for the virus, offers antiviral treatment or referral when appropriate, and maintains ongoing monitoring — matters enormously for outcomes at a population level.

The screening gap in plain terms

The 2030 target is 90% diagnosed. Australia is at 67.4%. The people not yet diagnosed are largely not failing to come forward — many simply don’t know there is anything to test for.

Hepatitis B can be entirely asymptomatic for decades. The liver does not have pain receptors in the way that, say, a muscle does. A person can carry chronic hepatitis B — with progressive liver inflammation and scarring occurring silently — and feel completely well. There is no visible signal. Without a blood test, there is no way to know.

RACGP guidance recommends hepatitis B screening for people born in high-prevalence regions, people who inject drugs, people who have had unprotected sex with multiple partners, and people with a known exposure history. In general practice, these screens often don’t happen — partly because of time pressure, partly because the question doesn’t arise naturally in a consultation about an unrelated issue, partly because neither patient nor clinician thinks to raise it.

2 cents

If you or a family member were born in Southeast Asia, the Pacific Islands, sub-Saharan Africa, or parts of Eastern Europe or the Middle East — and you haven’t had a hepatitis B blood test — this national surveillance report is a direct, data-backed reason to ask for one.

The test is three components from a single blood sample: hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core antibody (anti-HBc). Together these give a complete picture: current infection, immunity from vaccination, immunity from past infection, or susceptibility with no immunity. The result takes a few days and the conversation with your GP takes five minutes.

If you have already been told you have chronic hepatitis B and aren’t currently seeing anyone about it, this data makes the case for reconnecting with care. The antiviral medications now available can prevent the worst outcomes — cirrhosis, liver cancer, liver failure — but they require monitoring, prescribing, and ongoing engagement with a clinician.

This is general health information and does not constitute individual clinical advice.

Verdict

Verdict: yes — worth knowing about.

The diagnosis and treatment gap in hepatitis B in Australia is a preventable public health failure. The medications are available, PBS-listed, and effective. The barrier is awareness, access, and engagement. This national surveillance report is a direct call to action for patients, communities, and general practitioners — and the 2030 window, while narrowing, remains open. If you’re unsure whether you’ve been tested, your GP visit this week is the right time to ask.