Hepatitis B in Malaysia: symptoms, test results, the adult vaccine and living with it
Hepatitis B is a virus that infects the liver. Most adults who catch it clear it, but people infected as babies or young children often carry it for life, usually without symptoms, and it is the leading cause of liver cancer in Malaysia. A simple blood test tells you whether you have it or are protected, and a safe vaccine prevents it.
Key points
- About 1 million Malaysians are estimated to live with chronic hepatitis B. In one community study, only about 1 in 8 knew they had it.
- It spreads through blood and body fluids: from mother to baby at birth, through sex, and through shared needles, razors or toothbrushes. It doesn’t spread through sharing food, utensils, hugging or coughing.
- The HBsAg test shows whether you have the virus now. The anti-HBs test shows whether you are protected.
- Babies in Malaysia have been vaccinated since 1989. Adults who aren’t immune can have 3 doses, usually at 0, 1 and 6 months, at a GP clinic.
- People with chronic hepatitis B need check-ups every 6 to 12 months. Antiviral tablets, when needed, greatly lower the risk of cirrhosis and liver cancer.
What is hepatitis B? (Apa itu hepatitis B)
Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). It can be:
- acute: a new infection in the first 6 months. Most healthy adults clear the virus within a few months.
- chronic: when the virus stays for more than 6 months. This happens to about 9 in 10 babies infected at birth, about 3 in 10 young children, but fewer than 1 in 20 adults.
Over decades, chronic hepatitis B can scar the liver (cirrhosis) and cause liver cancer. Hepatitis B is the leading cause of liver cancer in Malaysia.
In Malaysia: before vaccination began in 1989, about 5 to 7% of people carried the virus. Rates are now much lower among those born after 1989. Even so, an estimated 1 million people live with chronic hepatitis B. Notified cases rose from 3,781 in 2021 to 8,138 in 2025, partly because more people are being tested, and Malaysia aims to eliminate hepatitis B as a public health threat by 2030.
How hepatitis B spreads, and how it doesn’t
| Can spread through | Doesn’t spread through |
|---|---|
| Mother to baby at birth | Sharing food, drinks or utensils |
| Sex without a condom | Hugging, kissing or holding hands |
| Sharing needles or drug equipment | Coughing or sneezing |
| Sharing razors, toothbrushes or nail clippers | Breastfeeding |
| Unsterile tattoo, piercing or medical equipment | Food or water |
So people with hepatitis B can work, eat with family and friends, and live normally. Household members and sexual partners should be tested and vaccinated.
Symptoms of hepatitis B
Many people, especially children, have no symptoms. When symptoms of a new infection occur, they usually start about 3 months after exposure:
- yellowing of the skin and eyes (jaundice)
- dark urine and pale stools
- tiredness, fever, loss of appetite, nausea and vomiting
- pain in the upper right tummy, and joint pain
Chronic hepatitis B is usually silent for years, which is why testing matters. See a doctor promptly if you develop jaundice.
Hepatitis B tests: what your results mean
The main blood tests are:
- HBsAg (hepatitis B surface antigen): positive means you have the virus now.
- Anti-HBs (surface antibody): positive means you are protected, from vaccination or past infection. A level of 10 mIU/mL or more counts as protected.
- Anti-HBc (core antibody): positive means you have been infected at some time.
| HBsAg | Anti-HBc | Anti-HBs | What it usually means |
|---|---|---|---|
| Negative | Negative | Negative | Not immune: get vaccinated |
| Negative | Negative | Positive | Protected by vaccination |
| Negative | Positive | Positive | Past infection, now cleared, and protected |
| Positive | Positive | Negative | Current infection: acute or chronic, depending on further tests |
If you have hepatitis B, your doctor will also check your liver function (ALT), the amount of virus (HBV DNA), and HBeAg, and may arrange an ultrasound or a FibroScan to check for liver scarring. Other combinations, such as anti-HBc positive on its own, need a doctor to interpret.
In pregnancy: antenatal clinics in Malaysia screen pregnant women for hepatitis B. Babies of mothers with hepatitis B are given the vaccine and an immunoglobulin injection soon after birth, and some mothers are given antiviral tablets late in pregnancy, which together prevent most infections in babies.
The hepatitis B vaccine
Children: under the National Immunisation Programme, babies get a hepatitis B dose within 24 hours of birth, then the 6-in-1 vaccine at 2, 3 and 5 months with a booster at 18 months. In December 2025 the Ministry of Health confirmed it would keep the universal birth dose. See our baby vaccination schedule.
Adults: if you were born before 1989 or aren’t sure you were vaccinated, ask for a blood test. If you aren’t immune, the usual adult course is:
- 3 doses, at 0, 1 and 6 months
- faster schedules are available, for example before travel or work, with an extra dose at 12 months
- a combined hepatitis A and B vaccine is also available, usually given at 0, 1 and 6 months
Especially recommended for:
- partners and household members of someone with hepatitis B
- healthcare workers, carers and others who may come into contact with blood
- people with chronic liver disease, kidney disease or on dialysis, diabetes, HIV or hepatitis C
- people who have several sexual partners or an STI, and people who inject drugs
- travellers and people moving to areas where hepatitis B is common
Protection lasts at least 20 years and probably for life, so healthy people don’t need routine boosters. Healthcare workers and others at ongoing risk usually have an anti-HBs test 1 to 2 months after the last dose to confirm they responded. If not, a second course is given. Side effects are usually just a sore arm and, sometimes, a mild fever.
Hepatitis B, FOMEMA and work
- Foreign workers: hepatitis B is one of the conditions tested in the FOMEMA medical exam. A positive HBsAg result currently means the worker is classed as unsuitable for employment in Malaysia. FOMEMA recorded 3,347 hepatitis B cases among foreign workers in 2023. See our guide to the FOMEMA medical check-up.
- Malaysian workers: some employers, especially in healthcare, ask for a hepatitis B test or proof of vaccination. Having hepatitis B doesn’t stop you doing most jobs, and international guidance says healthcare workers with hepatitis B shouldn’t automatically be excluded from work.
- Food handlers need a typhoid injection rather than a hepatitis B test, as hepatitis B doesn’t spread through food. See our guide to the typhoid injection for food handlers.
Living with chronic hepatitis B
- Regular check-ups: blood tests every 6 to 12 months, and for many people an ultrasound (often with an AFP blood test) every 6 months to look for early liver cancer.
- Treatment: not everyone needs medicine. If the virus is active or the liver is damaged, a specialist may start antiviral tablets such as tenofovir or entecavir, usually taken long term. They control the virus and greatly lower the risk of cirrhosis and liver cancer. They are available at government hospitals.
- Protect your liver: avoid alcohol, keep to a healthy weight, and check with your doctor before taking herbal remedies or new medicines.
- Protect others: make sure your partner and family are tested and vaccinated, use condoms with partners who aren’t immune, and don’t share razors or toothbrushes.
- Get vaccinated against hepatitis A if you aren’t immune, as a second infection can harm your liver.
Malaysia’s hepatitis services are still reaching only a minority of people with the infection, partly because it causes no symptoms. If you have a family member with hepatitis B, or were born before 1989 and have never been tested, ask your doctor for a test.
Where to get tested or vaccinated
GP clinics can test for hepatitis B, give the adult vaccine and refer you to a specialist if needed. Our directory lists GP clinics across Kuala Lumpur, Selangor and other states. Call ahead to check the vaccine is in stock.
Browse the clinic directoryFrequently asked questions
What is hepatitis B?
A virus that infects the liver. Most adults clear it, but people infected as babies or young children often carry it for life, which can lead to cirrhosis and liver cancer.
How do you get hepatitis B?
Through blood and body fluids: from mother to baby at birth, through sex, and by sharing needles, razors or toothbrushes. Not through sharing food, utensils, hugging or coughing.
What does a positive HBsAg mean?
That you have the hepatitis B virus now. Further tests show whether the infection is new or chronic and whether you need treatment.
How many doses of hepatitis B vaccine do adults need?
Usually 3 doses, at 0, 1 and 6 months. Faster schedules are available, with an extra dose at 12 months.
Do I need a hepatitis B booster?
Healthy people who completed the course usually don’t. Healthcare workers and others at ongoing risk may have a blood test to check they responded.
Is there a combined hepatitis A and B vaccine?
Yes. It is usually given as 3 doses at 0, 1 and 6 months, and protects against both viruses.
Can hepatitis B be cured?
Chronic hepatitis B usually can’t be cured, but antiviral tablets control it well and greatly lower the risk of liver damage and cancer.
Can a foreign worker with hepatitis B work in Malaysia?
Under current FOMEMA rules, a worker who tests positive for hepatitis B is classed as unsuitable for employment.
Sources
- Chronic viral hepatitis in Malaysia: “where are we now?” (2017)
- BMC Gastroenterology — Awareness and treatment of chronic hepatitis B in Malaysia (2022)
- The Star — Good progress against hepatitis (31 Jul 2026)
- Medical Journal of Malaysia — Antenatal hepatitis B screening in Kedah (Jul 2026)
- CodeBlue — MOH maintains universal hepatitis B vaccination for newborns (Dec 2025)
- CodeBlue — Additional foreign worker medical screening necessary, says MMA (Jan 2024)
- World Health Organization — Hepatitis B fact sheet (Jul 2026)
- US CDC — Hepatitis B testing and serology (Aug 2026)
- US CDC — Hepatitis B clinical overview (Aug 2025)
- NHS — Hepatitis B vaccine
