Hepatitis B: how is it tested for? Blood tests, vaccination, higher-risk groups, the Hepatitis B Co-care Scheme, and which specialty to see after diagnosis
People who are uncertain about their hepatitis B status should get tested, generally with blood tests for hepatitis B surface antigen and surface antibody (Department of Health Viral Hepatitis Control Office, July 2026); the Primary Healthcare Commission launched the Hepatitis B Co-care Scheme in February 2026, which provides screening for eligible higher-risk people (Primary Healthcare Commission press release, January 2026). The treating doctor decides individual cases.
Do I need a blood test for hepatitis B? Who is at higher risk?
Hepatitis B infection can remain without symptoms until the liver has been seriously damaged; people who are uncertain about their hepatitis B status should get tested, and the test generally consists of blood tests for hepatitis B surface antigen (HBsAg) and surface antibody (anti-HBs) (Department of Health Viral Hepatitis Control Office hepatitis B information, July 2026).
The people at higher risk of infection are: family members (parents, siblings and children) and sexual partners of people with chronic hepatitis B, people who inject drugs, men who have sex with men, people with multiple sexual partners, people with HIV, people who receive blood or blood products on a regular basis, people on dialysis, and healthcare workers who may come into contact with patients' blood or body fluids at work (Department of Health Viral Hepatitis Control Office hepatitis B information, July 2026).
Chronic hepatitis B is found in about 1 in every 20 people in Hong Kong, mainly those born before 1988 who did not benefit from the Government's universal childhood hepatitis B immunisation programme; nearly 40% of them are unaware of their infection status, and about 70% have no medical follow-up for their liver disease (Department of Health press release, 28 July 2026).
How do I read the blood test result?
A positive surface antigen means the body has been infected with the hepatitis B virus and the person ‘should seek medical consultation as soon as possible’; a surface antigen that stays positive for more than 6 months means chronic hepatitis B has developed (Department of Health Viral Hepatitis Control Office hepatitis B information, July 2026). A negative surface antigen with a positive surface antibody means no infection has been found and there are adequate antibodies; if both are negative, no infection has been found but there is no immunity to hepatitis B, and vaccination should be considered (Department of Health Viral Hepatitis Control Office hepatitis B information, July 2026).
Individual results are interpreted by a doctor, and the treating doctor decides individual cases.
Where can I get tested for hepatitis B? What are the arrangements of the Hepatitis B Co-care Scheme?
Members of the public who want a hepatitis B test can consult a family doctor; for service details, appointments and charges, they should ask the doctor directly (Department of Health Viral Hepatitis Control Office, July 2026). For choosing a family doctor, see How to choose a family doctor.
The Primary Healthcare Commission launched the Hepatitis B Co-care Scheme in February 2026, under which eligible persons can enrol at District Health Centres/District Health Centre Expresses to receive a hepatitis B risk assessment, screening and long-term management (Department of Health Viral Hepatitis Control Office, July 2026; Primary Healthcare Commission press release, January 2026); as of 15 July 2026, around 33,000 people had enrolled (Department of Health press release, 28 July 2026). The arrangements of the Scheme are in the table below.
| Item | Arrangements announced by the Primary Healthcare Commission (26 January 2026) |
|---|---|
| Eligible persons | Must meet all of the following: born in or before 1988 (the year the universal childhood hepatitis B immunisation programme was introduced); a family member (parents, siblings and children) or a sexual partner has chronic hepatitis B; a Hong Kong resident with no known diagnosis of chronic hepatitis B and no related symptoms; has not completed the full course of hepatitis B vaccination (the last item is from the Scheme website FAQ, accessed 5 October 2026) |
| Enrolment | First register as a District Health Centre member, and agree to join eHealth |
| Screening phase | A free hepatitis B surface antigen rapid test at the District Health Centre, and pairing with a family doctor of the person's own choice; those with a positive rapid test receive a Government-subsidised further blood test at the paired family doctor's clinic; if the first blood test is positive, the family doctor generally arranges another blood test 6 months later to confirm; in the screening phase participants pay only a one-off co-payment, announced by the Government as HK$180 (the Scheme website FAQ, accessed 5 October 2026, states HK$180 or less); the Government subsidises up to 2 consultations with the family doctor, with a total consultation fee of HK$136 |
| After chronic hepatitis B is diagnosed | Up to 4 subsidised consultations a year, with the co-payment for each consultation set by the family doctor and recommended by the Government at HK$150 per consultation; the Scheme's basic drug list already includes antiviral drugs for treating hepatitis B, and participants prescribed these drugs do not pay for them |
How many doses of hepatitis B vaccine? Who should consider vaccination?
The complete course is 3 doses in total: the second dose is given 1 month after the first, and the third dose 5 months after the second; if there is a delay, there is no need to restart, and the remaining doses should be given as soon as possible (Department of Health Viral Hepatitis Control Office hepatitis B vaccine information, May 2026). After the 3 doses, more than 95% of healthy people can produce protective antibodies (Department of Health Viral Hepatitis Control Office hepatitis B vaccine information, May 2026).
The higher-risk groups should consider hepatitis B vaccination; adults can have a blood test before vaccination: those who already have surface antibody do not need vaccination, and for those who are already infected ‘vaccination will not be effective’ and they should consult a doctor, so only people who are not infected and have no antibody need the vaccine; people who have had an allergic reaction to the hepatitis B vaccine or to any component of the vaccine (for example yeast) should not be vaccinated (Department of Health Viral Hepatitis Control Office hepatitis B vaccine information, May 2026). Anyone who wants vaccination can consult a family doctor (Department of Health Viral Hepatitis Control Office hepatitis B vaccine information, May 2026).
Hong Kong has run a universal childhood hepatitis B vaccination programme since 1988: newborn babies receive the first dose in hospital at birth, and the second and third doses at 1 month and 6 months of age (Department of Health Viral Hepatitis Control Office hepatitis B vaccine information, May 2026); for information on children's vaccines and other vaccines, see Children's vaccinations and travel vaccines.
What follow-up is needed after chronic hepatitis B is diagnosed? Which specialty should I see?
Antiviral medicines can effectively inhibit hepatitis B virus replication and reduce the risk of cirrhosis, liver failure and liver cancer; doctors decide when antiviral treatment is needed according to the patient's liver function, viral load, degree of liver fibrosis and whether there are complications (Department of Health Viral Hepatitis Control Office hepatitis B information, July 2026). People with chronic hepatitis B need regular follow-up and related tests, for example blood tests for liver function, alpha-fetoprotein (AFP) and viral load, and a liver ultrasound; they must take their medicines as the doctor instructs, and ‘do not self-adjust or self-discontinue the medication even when the viral load is suppressed or the liver function is restored to normal’ (Department of Health Viral Hepatitis Control Office hepatitis B information, July 2026). About 15% to 40% of people with chronic hepatitis B who are not treated develop cirrhosis or liver cancer in the long run (Department of Health Viral Hepatitis Control Office hepatitis B information, July 2026).
Family members and sexual partners of people with chronic hepatitis B should have a blood test as soon as possible, and should be vaccinated if they have no hepatitis B antibodies and are not infected (Department of Health Viral Hepatitis Control Office hepatitis B information, July 2026).
Adults with stable chronic hepatitis B and no complications can have assessment, clinical and laboratory monitoring, antiviral treatment and, when needed, liver cancer surveillance in primary care; patients with severe or complex conditions need to be managed by a hepatologist (Primary Healthcare Commission (Health Bureau), ‘Management of Adults with Chronic Hepatitis B in Primary Care’, first issued January 2026, for primary care doctors). The guideline lists for primary care doctors the situations in which to refer to a hepatologist for early assessment: unexplained deranged liver function, severe acute hepatitis or acute-on-chronic liver failure, virological breakthrough during antiviral treatment, and abnormal alpha-fetoprotein; it also lists groups of patients who need specialist care, for example people with cirrhosis, people with liver lesions, or people co-infected with hepatitis C or HIV (Primary Healthcare Commission chronic hepatitis B primary care guideline, January 2026). For symptoms and signs of acute liver failure (hepatic encephalopathy, jaundice) or an international normalised ratio (INR) of 1.5 or above, urgent referral to the Accident and Emergency Department is required (Primary Healthcare Commission chronic hepatitis B primary care guideline, January 2026, for primary care doctors).
Gastroenterology and Hepatology is an adult internal medicine specialty that deals with the prevention, investigation, diagnosis and treatment of diseases of the digestive tract, pancreas, liver and biliary tract (Hong Kong Academy of Medicine, Specialty Descriptions, April 2025); for choosing a gastroenterologist, see How to choose a gastroenterologist. Which specialty follows up an individual patient is decided by the treating doctor.
Frequently asked questions
How is hepatitis B tested for?
Hepatitis B tests generally consist of blood tests for surface antigen (HBsAg) and surface antibody (anti-HBs); members of the public can consult a family doctor, and should ask the doctor about service details, appointments and charges (Department of Health Viral Hepatitis Control Office, July 2026). The treating doctor decides individual cases.
Who is at higher risk of hepatitis B?
The people at higher risk of hepatitis B infection are: family members and sexual partners of people with chronic hepatitis B, people who inject drugs, men who have sex with men, people with multiple sexual partners, people with HIV, people who receive blood or blood products on a regular basis, people on dialysis, and healthcare workers who may come into contact with patients' blood or body fluids at work (Department of Health Viral Hepatitis Control Office, July 2026).
How many doses of hepatitis B vaccine are needed?
The hepatitis B vaccine is 3 doses in total: the second dose 1 month after the first, and the third dose 5 months after the second; after completion, more than 95% of healthy people can produce protective antibodies (Department of Health Viral Hepatitis Control Office hepatitis B vaccine information, May 2026). Adults can have a blood test before vaccination, and those who already have surface antibody do not need vaccination (Department of Health Viral Hepatitis Control Office hepatitis B vaccine information, May 2026).
Who is eligible for the Hepatitis B Co-care Scheme?
Eligible participants in the Hepatitis B Co-care Scheme must meet all of the following: born in or before 1988, have a family member (parents, siblings and children) or a sexual partner who has chronic hepatitis B, and have no known diagnosis of chronic hepatitis B and no related symptoms (Primary Healthcare Commission press release, January 2026); they must also not have completed the full course of hepatitis B vaccination (Scheme website FAQ, accessed October 2026). In the screening phase, participants pay only a one-off co-payment of up to HK$180 (Primary Healthcare Commission press release, January 2026). The Scheme's arrangements are subject to what is currently announced.
Which specialty should I see for chronic hepatitis B?
Patients with stable disease and no complications can be managed in primary care, and those with severe or complex conditions are managed by a hepatologist (Primary Healthcare Commission (Health Bureau) guideline, first issued January 2026, for primary care doctors); which specialty follows up an individual patient is decided by the treating doctor.