Hepatitis B screening and treatment (Hepatitis B screening and management)

A blood test that checks for the hepatitis B virus, and the long-term monitoring and medicine that protect the liver if the infection becomes long-lasting.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

A blood test shows whether you have hepatitis B, have cleared it, or are protected by vaccination.
Chronic hepatitis B is usually controlled rather than cured: monitoring and, when needed, antiviral medicine protect the liver long term.
Not everyone needs treatment immediately, but lifelong monitoring matters because the risk of liver damage and cancer can change over time.
Hepatitis B is vaccine-preventable, and treating mothers plus vaccinating babies greatly reduces passing it on.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeBlood test, with long-term monitoring and medicine if needed

AnaestheticNot needed

How long it takesBlood test takes minutes; care can be lifelong

Hospital stayOutpatient; no hospital stay needed

Time off workUsually none

When you'll see resultsBlood results usually within days

On the NHS?Testing, vaccination and specialist treatment are available free on the NHS when clinically indicated

A general guide. Your specialist will give you advice for your situation.

Best fit

Finds infection early, often before any symptoms or liver damage

Pause if

A single test cannot, on its own, tell you everything; the pattern of markers and further tests decide what is happening.

Main recovery point

You carry on as normal and may have a small bruise. The result usually comes back within days and is explained to you.

Good aftercare

A named specialist team and clear contact route for results and concerns.

After the blood test

You carry on as normal and may have a small bruise. The result usually comes back within days and is explained to...

If chronic infection is found

You are referred to a specialist for further tests to assess how active the virus is and whether your liver is...

Starting any medicine

If antivirals are started, you take a daily tablet. A blood test is often done about a month later, then regularly...

Ongoing monitoring

You are reviewed every few months to a year, with blood tests and, for some, liver scans, to watch the virus and...

Medical line illustration of hepatitis antiviral treatment for Hepatitis B screening and treatment. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is hepatitis B testing and treatment?

Hepatitis B is an infection caused by a virus that affects the liver. It spreads through blood and body fluids, including from mother to baby around birth, through sex, and through sharing needles. A blood test checks whether you have the virus, have had it in the past, or are protected by vaccination.

In adults, the body often clears the virus within six months (acute infection). In some people, and in most babies who catch it, the virus stays in the body long term. This is called chronic hepatitis B and is the part that needs ongoing attention.

Chronic hepatitis B usually cannot be cured, but it can be controlled. Regular monitoring and, when needed, antiviral medicine keep the virus in check and reduce the risk of long-term liver damage (cirrhosis) and liver cancer. Not everyone with chronic infection needs medicine straight away, but everyone benefits from monitoring.

Hepatitis B is also preventable. A safe, effective vaccine protects people who are not already infected, and treating a mother in pregnancy with vaccination of the baby greatly reduces passing it on.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Screening blood test

A blood sample is checked for markers of the virus (such as the surface antigen, HBsAg), past infection, and immunity from vaccination. Offered routinely in pregnancy and to people at higher risk.

Assessment of chronic infection

If chronic hepatitis B is found, further blood tests, a fibroscan or ultrasound and sometimes other tests assess how active the virus is and whether the liver is affected.

Monitoring without medicine

Many people with chronic hepatitis B do not need treatment at first and are monitored regularly so that medicine can be started at the right time if things change.

Antiviral treatment

Medicines such as tenofovir or entecavir suppress the virus to protect the liver. They are usually taken long term, often indefinitely, with regular blood tests.

Prevention: vaccination

A safe, effective vaccine protects people who are not infected. Babies in the UK are offered it routinely, and at-risk groups and contacts can be vaccinated free on the NHS.

Hepatitis B vs hepatitis C

Feature	Hepatitis B	Hepatitis C
Vaccine?	Yes	No
Usual outcome	Often controlled long term	Usually curable with tablets
Treatment	Antivirals, often indefinite	Short course of direct-acting antivirals
Monitoring	Often lifelong	Mainly until cure confirmed

People with one virus are often tested for the other, and for HIV, as they can be caught together.

Preparing for your treatment

You do not usually need to fast or stop medicines before the blood test.
Tell the clinician about any risk factors, your country of birth, family history of hepatitis or liver cancer, and any past test results.
Mention all medicines and supplements, as some affect the liver and others interact with antivirals.
If you might be pregnant or are planning pregnancy, say so, as this affects monitoring and protecting the baby.
Ask whether household members and sexual partners should be tested and offered vaccination.
If treatment is being considered, ask about kidney and bone monitoring, as some antivirals can affect these.
Bring details of any alcohol use and other liver risks, as these add to the picture.

What happens

Screening is a simple blood test. A healthcare worker takes a sample from your arm and it is sent to a laboratory. The result, usually back within days, shows whether you have current infection, past infection or immunity from vaccination.

If chronic hepatitis B is found, you are usually referred to a liver or infectious-diseases specialist. Further tests assess how active the virus is and whether the liver is affected, often including a fibroscan or ultrasound to check the liver's stiffness and appearance.

Based on these results, your specialist decides whether you need antiviral medicine now or careful monitoring. If medicine is started, it is usually a single daily tablet, with regular blood tests to check the virus is controlled and that your kidneys and liver are well.

You are then followed up long term, because the right time to start, change or continue treatment can shift over the years.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

A single test cannot, on its own, tell you everything; the pattern of markers and further tests decide what is happening.
Antiviral treatment is not needed by everyone with chronic infection straight away; some people are better monitored for now.
Stopping antivirals on your own is not safe, as the virus can flare and damage the liver.
Vaccination does not treat existing infection; it protects people who are not already infected.

Delay or rearrange if…

An acute infection may be allowed to settle, as adults often clear the virus, with monitoring rather than immediate antivirals.
Pregnancy changes monitoring and the plan to protect the baby, and is managed with a specialist.
Kidney problems may influence the choice and timing of certain antivirals.
Unclear or borderline results may need repeating before decisions are made.

Alternatives to discuss

Active monitoring without medicine for chronic infection that is not yet active
Different antiviral medicines (such as tenofovir or entecavir) chosen to suit your health
Vaccination for contacts who are not infected, to prevent spread
Lifestyle measures, such as limiting alcohol, to protect the liver
Referral to a specialist liver service for complex situations

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Benefits

Finds infection early, often before any symptoms or liver damage
Allows monitoring so treatment starts at the right time
Antiviral medicine controls the virus and lowers the risk of cirrhosis and liver cancer
Surveillance can pick up liver problems and cancer early, when they are more treatable
Identifies people who are not infected so they can be protected by vaccination
Helps protect partners, household members and babies from infection

Risks & complications

More common

Brief discomfort or a small bruise from the blood test
Anxiety about a long-term diagnosis and the need for ongoing monitoring
Regular blood tests and clinic visits if you have chronic infection

Less common

Mild side effects from antiviral medicine, such as nausea or tiredness
Needing extra tests if results are unclear or change
Effects on kidney or bone health with some antivirals, which are monitored
A scan or test showing changes that need further investigation

Rare but serious

A flare of the virus if antiviral medicine is stopped, which can harm the liver
Serious medicine reactions
Progression to advanced liver disease despite monitoring, particularly if treatment is delayed or missed

The biggest risks come from chronic infection going unmonitored, not from the test itself. Antiviral medicine for hepatitis B should not be stopped without specialist advice, because the virus can flare and damage the liver. Tell your specialist about kidney or bone problems and all other medicines, and ask how often you will be monitored for liver cancer if you are at higher risk.

Published figures to discuss

How hepatitis B behaves varies a great deal between people. Most adults clear acute infection, while most infected babies develop chronic infection; the chance of long-term liver damage depends on how active the virus is, other liver risks such as alcohol, and whether treatment and monitoring happen. Because these outcomes differ so widely by age, virus activity and individual circumstances, we have not quoted single percentages here; your specialist can explain the figures most relevant to your situation.

Figure	Reported range	How to interpret it	Source / confidence
Adults clearing acute hepatitis B	Most adults clear infection naturally	Babies and young children are much more likely to develop chronic infection, which is why newborn prevention is so important.	NHS — Hepatitis Bnhs.ukSource-linked context
Chronic hepatitis B complications	Long-term risk varies with viral activity and liver scarring	Cirrhosis and liver cancer risk are the reasons for specialist monitoring, antiviral treatment and ultrasound surveillance when indicated.	NHS — Hepatitis Bnhs.ukSource-linked context
Antiviral treatment suppresses rather than always cures	Common treatment reality	Many patients take long-term treatment to keep the virus controlled; stopping without specialist advice can cause flare.	Guide sourcesClinical context
Transmission to household or sexual contacts	Preventable	Contacts should be tested and vaccinated where appropriate; pregnancy needs specialist prevention planning for the baby.	Guide sourcesClinical context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

The blood test itself has no recovery. 'Afterwards' is about understanding your result, and, if you have chronic infection, settling into long-term monitoring and treatment that protect your liver.

After the blood test

You carry on as normal and may have a small bruise. The result usually comes back within days and is explained to you.

If chronic infection is found

You are referred to a specialist for further tests to assess how active the virus is and whether your liver is affected.

Starting any medicine

If antivirals are started, you take a daily tablet. A blood test is often done about a month later, then regularly to check the virus is controlled.

Ongoing monitoring

You are reviewed every few months to a year, with blood tests and, for some, liver scans, to watch the virus and protect the liver.

If treatment changes

Treatment may be started, adjusted or, rarely and only under specialist guidance, stopped, with closer monitoring around any change.

What's normal — and not a worry

A small bruise after the blood test
No symptoms at all, as chronic hepatitis B is often silent
Settling into a routine of regular blood tests and reviews
Mild, usually temporary side effects if you start antiviral medicine

Aftercare

Attend all monitoring blood tests and reviews, even when you feel completely well.
Take any antiviral medicine exactly as prescribed and never stop it without specialist advice.
Tell every doctor, dentist and pharmacist that you have hepatitis B so liver effects and interactions are considered.
Limit alcohol and ask about other ways to protect your liver.
Encourage household members and sexual partners to be tested and vaccinated.
Have any liver-cancer surveillance scans you are offered if you are at higher risk.
Use support services such as the British Liver Trust for information and help.

Before your treatment

Your next monitoring appointment booked
A reliable system for taking daily medicine if prescribed
An up-to-date list of all your medicines and supplements
A plan for partners and household members to be tested and vaccinated
A note of your result and what it means
The specialist team's contact details saved

⚠ Get urgent help if…

Yellowing of the skin or eyes (jaundice), dark urine or pale stools — seek medical advice promptly.
Severe tummy pain, swelling of the abdomen or legs, or vomiting blood — seek urgent help.
Confusion or unusual drowsiness, which can signal serious liver problems.
A serious rash, fever or feeling very unwell after starting a new medicine.
Stopping or running out of antiviral medicine — contact your specialist before there is a gap, as the virus can flare.

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A negative screening result usually means you do not have hepatitis B; the test may also show whether you are protected by vaccination. A positive result is interpreted by which markers are present, showing whether infection is recent, long-standing, active or controlled.

For chronic hepatitis B, a good outcome is the virus kept suppressed with the liver protected, rather than a one-off 'cure'. Some people clear the surface antigen over time, but for most, success means long-term control. Monitoring continues because the picture can change.

How long it lasts

Chronic hepatitis B is usually a lifelong condition. Antiviral treatment is often taken indefinitely, and stopping is considered only in specific situations and under close specialist supervision, because the virus can flare. Even people who do not need medicine need long-term monitoring, as the activity of the virus and the risk to the liver can change with time. A negative test does not protect you from future infection unless you are vaccinated.

Related tests, treatments or support

Hepatitis B testing is often done with tests for hepatitis C and HIV, because these can be caught together. Some HIV medicines also treat hepatitis B, so care is coordinated if you have both. People with chronic hepatitis B may also be checked for hepatitis D. Vaccination of contacts is arranged alongside diagnosis.

Follow-up & long-term care

If you have chronic hepatitis B, you are followed up long term by a liver or infectious-diseases service, usually every few months to a year. Reviews check blood tests, the response to any medicine, and the health of your liver, with scans for those at higher risk of liver cancer. Your specialist team is your point of contact for results and concerns.

Attend regular blood tests and reviews for life, even when well.
Take antiviral medicine consistently if prescribed, and never stop without advice.
Have liver-cancer surveillance scans if you are at higher risk.
Keep alcohol within recommended limits to protect your liver.
Ensure partners and household members are tested and vaccinated.
Keep your medicines list current to avoid harmful interactions.

Repeat, follow-on and what comes next

Treatment may be started, switched or, rarely and only under specialist supervision, stopped, depending on how the virus behaves.
Monitoring intervals change over time as the activity of the virus changes.
Results sometimes need repeating to confirm a change before acting.
Liver-cancer surveillance is added or intensified for those at higher risk.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

A named specialist team and clear contact route for results and concerns.
Regular, explained blood-test monitoring and liver assessment.
Liver-cancer surveillance for those at higher risk.
Support to take antiviral medicine consistently and never stop it abruptly.
Arranging testing and vaccination for contacts, with non-judgemental support.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Whether you use free NHS testing and care or pay privately
The number and type of blood tests and liver scans (such as fibroscan or ultrasound)
Specialist consultation and how often you are reviewed
Antiviral medicine if treatment is needed
Liver-cancer surveillance scans for those at higher risk
Vaccination for contacts who are not infected

Make sure your written quote includes

Which tests and scans are included in the assessment
Whether specialist review and monitoring are included and how often
Whether antiviral medicine is covered if treatment is needed
Whether liver-cancer surveillance is included for higher-risk patients
How results are communicated and who is the point of contact
What happens if results are unclear or treatment needs changing

On the NHS? Hepatitis B testing, vaccination and specialist treatment are available free on the NHS when clinically indicated; private care is mainly used for speed, convenience or travel-related vaccination.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

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Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

What do my specific test results mean — is this recent, long-standing, active or controlled?
Do I need antiviral medicine now, or careful monitoring for now?
How often will I be monitored, and will I need liver-cancer surveillance scans?
If I start medicine, what are the side effects and what is monitored?
Should my partner and household be tested and vaccinated?
What should I avoid, and how do I best protect my liver?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my treatment, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this treatment not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Can hepatitis B be cured?

Chronic hepatitis B is usually controlled rather than cured. Antiviral medicine keeps the virus in check and protects the liver, and some people clear the virus over time, but most need long-term monitoring.

Is there a vaccine?

Yes. A safe, effective vaccine protects people who are not already infected. Babies in the UK are offered it routinely, and at-risk groups and contacts can be vaccinated free on the NHS.

Do I need treatment straight away?

Not always. Many people with chronic hepatitis B are monitored rather than treated at first, so medicine can start at the right time if the virus becomes more active.

Will I pass it to my family?

The risk can be greatly reduced. Partners and household members can be tested and vaccinated, and treating a mother in pregnancy with vaccinating the baby strongly protects newborns.

Is testing and treatment free on the NHS?

Yes. Testing, vaccination and specialist treatment are available free on the NHS when clinically indicated.

What does long-term monitoring involve?

Usually regular blood tests, sometimes a liver scan, and for those at higher risk, surveillance for liver cancer, so problems can be picked up and treated early.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Hepatitis B NICE CG165 — Hepatitis B (chronic): diagnosis and management British Liver Trust — Hepatitis B UKHSA — Hepatitis B: guidance, data and analysis NICE CG165 — Information for the public: drug treatment

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.