Testing is indicated in all people in the priority populations described in this section. Most new cases of chronic hepatitis B infection diagnosed in Australia occur in people from CALD backgrounds. Testing people born in countries with intermediate and high prevalence of HBV, including new arrivals to Australia is a crucial part of Australia’s public health response to HBV. Section 3.1 and Figure 1 identify populations that are at greater risk of infection.

It is recommended that an individual’s risk of HBV infection should inform the decision to perform an HBV test. In appropriate clinical circumstances, the absence of a declared risk should not preclude HBV testing. Clinical suspicion of HBV infection may occur in the context of:

  • birth in an intermediate or high prevalence country (see Figure 1)
  • being an Aboriginal or Torres Strait Islander person
  • children of women who are HBsAg positive
  • unvaccinated adults at higher risk of infection (see Priority populations for HBV testing)
  • individual or family history of chronic liver disease or liver cirrhosis
  • individual or family history of hepatocellular carcinoma (HCC)
  • evaluation of abnormal liver function tests
  • acute hepatitis
  • family, sexual or household contact with a person known or suspected to have hepatitis B.

Other situations where HBV testing may be indicated:

  • pregnant women or women contemplating pregnancy  (see section 8.1)
  • healthcare workers who perform or may be expected to perform EPPs. Healthcare workers must take reasonable steps to know their hepatitis B , HIV and hepatitis C status
  • contact tracing where exposure to blood or body fluids of a person with the infection is documented
  • diagnosis of another infection with shared mode of acquisition, such as hepatitis C virus (HCV) or HIV
  • a person who reports a reactive HBV result from a test not licensed in Australia;
  • on the diagnosis of other conditions that may be caused by HBV infection e.g. glomerulonephritis, vasculitis
  • a person who requests an HBV test in the absence of declared risk factors – a small number of individuals request an HBV test but choose not to disclose their risk factors. An individual’s choice not to declare risk factors should be recognised and it is recommended that HBV testing be offered.