The legal framework
Hepatitis B is common in Zambia and frequently coexists with HIV. Infant vaccination is part of routine immunisation from six weeks, without a universal birth dose. Because several antiretroviral regimens also suppress hepatitis B, much of the treatment in practice is delivered through HIV services, which makes co-infection status important to establish.
Zambia includes hepatitis B in the pentavalent vaccine from six weeks and does not routinely give a birth dose. Screening is most developed within HIV services, where hepatitis B testing is part of assessment before starting treatment, because the drugs used against HIV also act on hepatitis B and the choice of regimen depends on it.
Key points
| Prevalence | High, with frequent HIV co-infection |
|---|---|
| Infant vaccination | Routine from six weeks in the combined vaccine |
| Birth dose | Not universally implemented |
| HIV co-infection | Common; several antiretroviral regimens also treat hepatitis B |
| Testing | Available at public facilities; ask for it |
| Treatment | Often delivered through HIV services |
| Antenatal screening | Not universal |
In practice
- If you are living with HIV, ask whether you have been tested for hepatitis B: it changes which regimen is appropriate.
- Never stop an antiretroviral regimen that is also treating hepatitis B without specialist advice.
- Ask for testing during pregnancy.
- Household contacts of a carrier should be vaccinated.
Cost and coverage
Vaccination and testing are free in the public sector; treatment is often provided through HIV services.
Where to go
- Public health facilities and HIV clinics.
- University Teaching Hospital in Lusaka.
- National viral hepatitis programme.
Worth knowing
Stopping a regimen that also suppresses hepatitis B can cause a severe flare. If you have both infections, any change to treatment must be made with that in mind.
Frequently asked questions
Why does HIV treatment affect hepatitis B?
Because several antiretroviral drugs are also active against hepatitis B. Anyone starting HIV treatment should be tested for hepatitis B, since the regimen must be chosen accordingly — and stopping such a drug abruptly can cause a dangerous flare of hepatitis.
What does a positive result mean for a partner?
The partner should be tested and, if neither immune nor already vaccinated, vaccinated — the vaccine is highly effective and settles the question permanently. Condoms protect in the meantime. Chronic hepatitis B is not a reason to end a relationship: effective treatment suppresses the virus to very low levels, and a vaccinated partner is protected.
Official sources and links
- UN Human Rights Office — ratified treaties and country reviews
- ILO NATLEX — national legislation database