A3：Yes. If one partner is infected and the other doesn’t have antibodies, vaccination is recommended to produce protective immunity. If vaccination isn’t possible, use condoms to prevent infection. If the uninfected partner already has antibodies, there’s no risk. If both are carriers, they should still go for regular medical checkups.

Q４：If I already have hepatitis B, can vaccination make the infection go away?

A4：Once you’re already a carrier, the vaccine won’t help or create antibodies. You should continue with regular follow-up examinations.

Q５：How long does the hepatitis B vaccine last? Do I need a booster shot?

A5：You can confirm the vaccine’s effectiveness by checking for hepatitis B surface antibodies 1–6 months after your last dose. Around 95% of newborns and most adults develop antibodies, though older adults may have a lower response. Antibody levels gradually decrease over time but immune memory usually protects for at least 10 years. A booster dose may be given after 10 years if needed, usually just one shot.

Q６：Can an ultrasound detect a hepatitis flare-up?

A6：Ultrasound is essential for detecting liver cancer, but it usually cannot diagnose hepatitis flare-ups. Only in a few acute cases may slight changes appear on the scan. Most hepatitis activity can only be confirmed through blood tests that check liver function values.

Q７：If I’m not a hepatitis B carrier and have antibodies, does that mean I won’t get liver cancer?

A7：It depends on how the antibodies were produced. If they came from vaccination, you won’t develop liver cancer from hepatitis B. However, if they resulted from a past infection, small amounts of virus may still remain in your liver cells. The risk of liver cancer is much lower than for carriers, but it’s not zero.

Q８：If I can donate blood regularly, does that mean I don’t have hepatitis B or C and don’t need to worry about liver cancer?

A8：Being able to donate blood only means you don’t currently have detectable hepatitis B or C. It doesn’t guarantee you’re free from liver cancer risk. Other conditions like fatty liver, alcohol-related liver disease, or autoimmune hepatitis can also cause cirrhosis and cancer. In some people who had past hepatitis B infection, the virus may still remain hidden in liver cells even after recovery, so regular monitoring is still important.

Q９：Can chronic hepatitis B be cured? How do you know if it’s gone?

A9：The goal of hepatitis B treatment is to completely remove the virus from the body. Recovery means reaching these targets: 

1.Normal liver enzyme levels (AST, ALT).

2.Undetectable HBV DNA in blood.

3.Disappearance of the surface antigen (HBsAg).

4.Development of protective antibodies (Anti-HBs).

5.No inflammation or fibrosis seen in liver tissue.

Although no treatment can achieve all of these perfectly yet, hepatitis B can be controlled with medication. Even when these targets are met, regular follow-up is still needed.

Q１０：After treatment, does hepatitis B still cause liver cancer?

A10：Current interferon or antiviral drugs cannot completely eliminate the hepatitis B virus. Even after successful treatment, patients remain carriers and still face a risk of liver cancer. Regular medical checkups are necessary.

Q１１：Do all hepatitis B carriers need antiviral medicine? Can I buy it from a pharmacy?

A11：Not all hepatitis B carriers need antiviral medication. Whether treatment is necessary should be determined by a doctor. Antiviral drugs must be prescribed and supervised by a physician. Never take them on your own—they’re not “liver-protection pills” or supplements. Taking them without guidance may cause harm instead of help.

Q１２：If I take antiviral medicine, will I stop being a hepatitis B carrier?

A12：Antiviral medicine can effectively suppress the hepatitis B virus and reduce liver inflammation, helping to prevent cirrhosis and liver cancer. However, no drug can completely remove the virus from liver cells. Even after treatment, you are still considered a carrier and need regular checkups.

Q１３：Can I get pregnant while taking antiviral medicine for hepatitis B?？

A13：Among current hepatitis B medicines, only entecavir and tenofovir are classified as Category B, meaning they can be used during pregnancy. If you’re planning to get pregnant, please discuss it with your doctor beforehand to ensure safe treatment.。

Q１４：Do I need a liver biopsy before starting antiviral treatment?

A14：Not necessarily. In most cases, the doctor can use the viral load (HBV DNA test) instead of a liver biopsy to decide on treatment. Whether you need a biopsy depends on your individual condition.

Q１５：What should hepatitis B carriers pay attention to in their diet?

A15：For inactive carriers, chronic hepatitis B patients, or those with early cirrhosis, there are no strict dietary restrictions. Eat fresh, natural foods, and avoid overly processed, smoked, or pickled foods that may contain aflatoxins. Don’t smoke or drink alcohol. No food can “heal” or “strengthen” your liver overnight—balanced nutrition is the key.

Q１６：Can Chinese herbal medicine effectively treat hepatitis B?

A16：So far, no herbal medicine has been scientifically proven to treat or cure chronic hepatitis B. Many people think herbal remedies are mild, but they can also cause serious side effects or liver toxicity. Always consult a qualified doctor before taking any herbal product. Using unverified folk medicines, steroids, or supplements may trigger severe liver inflammation or even fatal liver failure.

Q１７：My child completed the hepatitis B vaccination schedule as a baby. Why is the antibody test now negative?

A17：The hepatitis B vaccine helps the body develop protective antibodies. However, antibody levels naturally decrease over time, which may result in a negative blood test. This doesn’t necessarily mean the protection is gone, as immune memory still remains.

Q１８：Does a negative antibody result mean my vaccine protection is gone?

A18：Since July 1986, Taiwan has implemented a nationwide hepatitis B vaccination program for all newborns.The Ministry of Health and Welfare and the medical community have continuously monitored and studied the vaccine’s effectiveness and antibody response for more than 30 years, with extensive research conducted by local experts and scholars.According to studies, most individuals who test negative for hepatitis B antibodies still retain cellular immune memory. In addition, the chronic carrier rate among vaccinated generations has not increased, and the number of acute hepatitis B cases reported in recent years has not risen. These findings indicate that the hepatitis B vaccine remains effective in preventing infection.Therefore, for individuals who have completed the full vaccination schedule but test negative for hepatitis B surface antibodies, the Advisory Committee on Immunization Practices (ACIP) recommends no need for routine booster doses. The World Health Organization and other advanced countries, including the United States, follow the same recommendation.

Q１９：What if a high-risk person completes all three booster doses but still has no antibodies?

A19：Since 5–10% of individuals may fail to develop immunity even after receiving the hepatitis B vaccine, those who have completed two full vaccination series but still do not produce antibodies do not need additional doses. Instead, they should follow appropriate preventive measures against hepatitis B and undergo regular monitoring of hepatitis B surface antigen (HBsAg) levels.

For individuals who have completed the full hepatitis B vaccination schedule but test negative for hepatitis B antibodies, certain groups may still require a booster dose.Since hepatitis B virus is mainly transmitted through body fluids or blood—via close contact, blood transfusion, or injection—the Advisory Committee on Immunization Practices (ACIP) recommends that the following high-risk groups may receive one additional self-paid booster dose:

1. Patients undergoing hemodialysis, organ transplant recipients, individuals receiving blood products, and those with immune deficiencies.

2. People with multiple sexual partners or those who use injection drugs.

3. Household members or sexual partners of hepatitis B carriers.

4. Residents and staff of institutions for individuals with physical or intellectual disabilities.

5. Healthcare and public health workers who may be exposed to blood or body fluids. People in the above categories may receive one self-paid booster dose of the hepatitis B vaccine. A blood test should be performed one month later. If the hepatitis B surface antibody remains negative (less than 10 mIU/mL), they should complete the remaining second and third doses according to the 0–1–6 month schedule.

Q２０：Besides getting vaccinated, what other ways can hepatitis B be prevented?

A20：

1. Always use disposable or properly sterilized needles for injections, acupuncture, ear piercing, or tattooing. Avoid unnecessary procedures such as blood transfusions, injections, acupuncture, tattoos, or piercings.

2. Maintain good personal hygiene. Do not share razors, toothbrushes, needles, scraping tools, or nail clippers to prevent cuts or breaks in the skin or mucous membranes that could lead to infection.

3. Always use condoms correctly and consistently during sexual activity. Avoid unprotected sex, multiple sexual partners, or commercial sex activities.

Q２１：If my test result shows positive for the hepatitis B surface antigen (HBsAg), what should I do?

A21：A positive HBsAg test result means that hepatitis B virus is present in your body, which may indicate either an acute or chronic infection. It is recommended to follow your doctor’s advice for regular blood tests and ultrasound examinations.

You should also pay attention to the following points:

1. Avoid seeking unverified treatments or taking over-the-counter medicines or folk remedies, as these may increase the burden on your liver.

2. Do not donate blood or share personal items such as toothbrushes, razors, or beauty tools with others.

3. Your spouse or sexual partner should get a blood test, and if they have not been infected with hepatitis B, they should receive the hepatitis B vaccination. 

Source: Taiwan Liver Research Foundation