One in 20 Hongkongers has chronic hepatitis B, and 40% do not know they carry it

HONG KONG, 29 AUGUST 2026 —

Hong Kong has 410,000 residents living with chronic hepatitis B, yet 40% remain unaware of their infection, according to the government’s Viral Hepatitis Action Plan.

General practitioner Dr Wong Sze-man likens it to rush-hour transport. “When you take transport during rush hour and see 20 people, one of them is infected and is a silent carrier of the virus,” he says.

Chronic hepatitis B infection is the leading cause of liver cancer in Hong Kong, the city’s fifth most common cancer and third biggest killer. The virus is nearly 100 times more infectious than HIV and about ten times more infectious than hepatitis C. It can survive on surfaces for at least seven days and often hides in liver cells for life.

Wong says the silent progression means patients can feel fine for decades while the virus quietly replicates. “Around 15% to 40% of untreated chronic hepatitis B carriers will eventually develop liver complications such as cirrhosis and hepatocellular carcinoma,” he says.

Untreated chronic infection can lead to liver cancer without visible liver damage, Mak says. Regular surveillance with an ultrasound and blood tests every six months can detect early cancer and allow curative treatment such as surgical resection.

The Hong Kong government runs a “Hepatitis B co-care scheme,” offering free screening at District Health Centres and subsidised care in primary care settings. The Liver Foundation launched Hepatitis Testing Express in 2024 to provide free screening to all residents.

Stigma persists because many wrongly believe hepatitis only stems from drug or alcohol use, when most cases are passed from mother to child, Mak says. Another myth is that hepatitis C is a “death sentence,” even though modern oral antivirals cure more than 95% of infections within two to three months.

Wong’s six rules for liver protection start with vaccination against hepatitis A and B, especially before travel. He advises never sharing razors, toothbrushes or nail clippers; using sterile equipment for piercings and tattoos; avoiding raw shellfish and tap water overseas; practising safe sex; and moderating alcohol intake.

Hepatitis is liver inflammation, not a single virus, Mak notes. Five hepatitis viruses affect humans: A, B, C, D and E. Hepatitis G is sometimes listed but is not recognised as a disease-causing entity. The labels A and B were assigned in 1947, before the viruses were identified. Hepatitis C was pinpointed in 1989 after years as “non-A, non-B hepatitis.”