Hepatitis B – how it spreads and how to prevent it
How hepatitis B is transmitted in South Africa, why the childhood vaccine matters, who should be tested, and what living with long-term infection involves.
What hepatitis B is
Hepatitis B is a virus that infects the liver. Many people who catch it have no symptoms at all, which is why it spreads and why so many people carrying it do not know. In some people the infection becomes long-term, and over decades that can cause liver scarring and liver cancer. It is a significant cause of liver disease in sub-Saharan Africa.
- It spreads through blood and body fluids: from mother to baby around birth, through unprotected sex, through shared needles or unsterile equipment, and through contact with infected blood.
- The younger someone is when infected, the more likely the infection is to become long-term — which is why vaccinating infants matters so much.
- It does not spread through food, water, sharing cutlery, hugging or casual contact.
Vaccination is the main protection
Hepatitis B vaccine is part of South Africa's routine childhood immunisation schedule, given free at public clinics, and is recorded in the Road to Health booklet. Adults at higher risk can also be vaccinated.
The vaccine used to prevent hepatitis B:
Hepatitis B Vaccine — Engerix-B, Heberbiovac
Prevention of Hepatitis B; post-exposure prophylaxis; healthcare workers; haemodialysis patients
- Keep the Road to Health booklet safe and bring it to every visit — it is the record of which doses your child has had.
- Adults who may benefit include healthcare workers, people with a partner or household member who has hepatitis B, people who inject drugs, people on dialysis, and people with other liver disease. Ask a clinician whether it applies to you.
- A missed dose does not mean starting again. Go back to the clinic and continue the course.
Testing and living with hepatitis B
A blood test shows whether you have the infection, whether you are immune, or whether you need vaccination. Testing is worth asking about if you are pregnant, if a household member or partner has hepatitis B, if you have HIV, or if a blood test has ever shown abnormal liver results.
- Long-term infection is monitored rather than always treated. Regular check-ups track the liver, and treatment is started when it is needed.
- Some medicines used in HIV treatment also act against hepatitis B, so the two are managed together where both are present. Never stop that treatment on your own.
- Alcohol accelerates liver damage. If you have hepatitis B, cutting it out is one of the most useful things you can do.
- Tell any clinician prescribing for you, because some medicines are harder on the liver.
Common questions
- Is the hepatitis B vaccine free in South Africa?
- Yes. It is part of the routine childhood immunisation schedule at public clinics and is recorded in the Road to Health booklet. Ask a clinician whether adult vaccination applies to you.
- How is hepatitis B spread?
- Through blood and body fluids — from mother to baby around birth, through unprotected sex, and through shared needles or unsterile equipment. It does not spread through food, water or casual contact.
- Can hepatitis B be cured?
- Long-term hepatitis B is usually controlled rather than cured. Many people are monitored without treatment; medicines are started when the liver needs them, and they are taken long-term under supervision.
Sources
- National clinical guidelines and policy libraryNational Department of Health, South Africa
- Communicable disease surveillance and clinical guidanceNational Institute for Communicable Diseases, South Africa
- Clinical and public health guidanceWorld Health Organization
- Medicines Online Directory and approved patient information leafletsSouth African Health Products Regulatory Authority
Last reviewed 11 August 2026.