National Hepatitis B Strategy 2010–2013

5.4 Unvaccinated adults at higher risk of infection

Page last updated: July 2010

This population of interest for the prevention of hepatitis B transmission includes:

  • men who have sex with men
  • sex workers
  • people who inject drugs
  • partners and other household and intimate contacts of people who have acute or chronic hepatitis B infection
  • people in custodial settings
  • people with HIV or hepatitis C, or both
While the potential to progress from acute to chronic hepatitis B infection diminishes significantly following childhood, some unvaccinated adults remain at particular risk of hepatitis B infection and continue to have a low risk of progressing to chronic infection. More than 40 per cent of acute hepatitis B cases are attributed to injecting drug use, reflecting low levels of vaccine uptake among this population set. Both men who have sex with men and sex workers are at increased risk of infection, particularly if engaging in unprotected sex.

Protection against co-infection with hepatitis B is a priority for people with HIV or chronic hepatitis C to avoid the increased individual impact of disease experienced by those living with co-infections. People entering custodial settings have higher rates of previous hepatitis B infection compared to the general community but only around 50 per cent of people entering custodial settings have immunity to hepatitis B. Household or sexual contacts of people recently diagnosed with hepatitis B are also at increased risk of exposure to the hepatitis B virus.