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Background  Current estimates suggest over 218,000 individuals in Australia are chronically infected with hepatitis B virus. The majority of these people are migrants and refugees born in hepatitis B endemic countries, where attitudes towards health, levels of education, and English proficiency can be a barrier to accessing the Australian health care system, and best managing chronic hepatitis B. This study aimed to assess the knowledge of transmission and consequences of chronic hepatitis B among these patients.    Method  A prospective study was conducted between May and August 2012. Patients with chronic hepatitis B were recruited from three Royal Melbourne Hospital outpatient clinics. Two questionnaires were administered.  Questionnaire 1 , completed during observation of a prospective participants’ consultation, documented information given to the patient by their clinician. After the consultation,  Questionnaire 2  was administered to assess patient demographics, and overall knowledge of the effect, transmission and treatment of hepatitis B.    Results  55 participants were recruited. 93% of them were born overseas, 17% used an interpreter, and the average time since diagnosis was 9.7 years.  Results from  Questionnaire 1  showed that the clinician rarely discussed many concepts.  Questionnaire 2  exposed considerable gaps in hepatitis B knowledge. Few participants reported a risk of cirrhosis (11%) or liver cancer (18%). There was a high awareness of transmission routes, with 89% correctly identifying sexual transmission, 93% infected blood, and 85% perinatal transmission. However, 25% of participants believed hepatitis B could be spread by sharing food, and over 50% by kissing and via mosquitoes. A knowledge score out of 12 was assessed for each participant. The average score was 7.5. Multivariate analysis found higher knowledge scores among those with a family member also diagnosed with chronic hepatitis B and those routinely seeing the same clinician (p = 0.009 and p = 0.002, respectively).    Conclusion  This is the largest Australian study assessing knowledge and understanding of the effect, transmission, and treatment of hepatitis B among chronically infected individuals. The findings highlight the knowledge gaps and misconceptions held by these patients, and the need to expand education and support initiatives.    Electronic supplementary material  The online version of this article (doi:10.1186/1471-2334-14-537) contains supplementary material, which is available to authorized users.

Health literacy in patients with chronic hepatitis B attending a tertiary hospital in Melbourne: a questionnaire based survey