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Hepatitis B

Learn about the symptoms, causes, treatments, questions and conditions related to Hepatitis B

Key Points

  • Hepatitis B is a viral infection that can cause liver failure and liver cancer. It is spread through contact with blood or bodily fluids from an infected person and can live on surfaces for up to 7 days.
  • Vaccination can prevent nearly 100% of hepatitis B infections, but there is no cure once infected.
  • While around 90% of adult cases resolve on their own, 10% develop chronic hepatitis B infection. For children, the likelihood of a chronic infection is much higher (around 50%).
  • According to the U.S. Department of Health and Human Services, around 850,000 people in the United States are estimated to be living with hepatitis B, but the actual number could be as high as 2.2 million.
  • Symptoms of hepatitis B include fever, darkened urine, yellowing of the skin and eyes (jaundice), joint pain, weakness and fatigue, loss of appetite, nausea and vomiting, and abdominal pain. Chronic hepatitis B infections can lead to advanced liver diseases such as cirrhosis of the liver or liver cancer.

What is Hepatitis B?

Hepatitis B is a viral infection caused by the hepatitis b virus (HBV) which attacks the liver, and can cause life-threatening complications, including liver failure and liver cancer. Hepatitis B is nicknamed “the silent epidemic” because many people are unaware that they are infected.

The CDC notes that vaccination can prevent nearly 100% of hepatitis B infections, however there is no cure once infected. While there is no cure of hepatitis B, many adult cases resolve on their own.

According to the Hepatitis B Organization, around 90% of people who become infected as adults will recover. The remaining 10% of infected adults will develop a chronic hepatitis B infection.

For children, the likelihood of a chronic hepatitis B infection is much higher. Around 50% of children who become infected will develop chronic hepatitis B, notes the Hepatitis B Organization.

Causes of hepatitis B

Hepatitis B is caused by contact with blood or bodily fluids from an infected person and can live on surfaces for up to 7 days.

How common is hepatitis B?

According to the U.S. Department of Health and Human Services, around 850,000 people in the United States are estimated to be living with hepatitis B. That estimate could be as high as 2.2 million, because most people who have hepatitis B are unaware that they are infected. Hepatitis B is more common in countries with lower vaccination rates, like parts of Africa.

According to the HHS, there has been a steady rise of hepatitis B cases since the early 2000’s, mostly due to an increase in injectable drug use.

How is hepatitis B transmitted?

Hepatitis B is commonly transmitted through contact with blood or body fluids, says the CDC; such transmissions include:

  • sex with an infected person
  • sharing drug injection tools
  • accidental needle-stick in a healthcare setting
  • tattooing and piercing with improperly cleaned equipment
  • exposure to infected blood, saliva, vaginal fluids, or semen
  • from mother to child during childbirth

Hepatitis B risk factors

Anyone is at risk of being exposed to hepatitis B, however, the CDC notes that there are some factors that raise the risk of exposure, including:

  • infants born to mothers who have hepatitis b
  • using injectable drugs
  • sex with anonymous or multiple partners
  • men who have sex with other men
  • living with someone who has hepatitis b
  • working in a healthcare setting
  • working in a public safety setting
  • receiving dialysis treatments for kidney disease
  • visiting certain countries here hepatitis b is more common
  • having HIV
  • prison inmates
  • having a history of sexually transmitted infections

Signs and symptoms of hepatitis B

Many people do not exhibit symptoms of hepatitis B, especially adults. However, according to The Liver Foundation, symptoms when they do appear include:

What are the early warning signs of hepatitis B?

Many hepatitis B infections go unnoticed, for lack of symptoms. Other than risk factors, there are no early warning signs besides the possible symptoms.

Symptoms can appear anywhere from a couple weeks to several months after exposure, according to the Mayo Clinic.

What are the symptoms of advanced liver disease?

Chronic hepatitis B infections can lead to advanced liver diseases such as cirrhosis of the liver, or liver cancer. According to the CDC, symptoms of advanced liver disease are:

  • Yellowing of the skin and eyes (a condition called jaundice)
  • Itchy skin
  • Dark urine and tarry or clay-like bowel movements
  • Easily bruised
  • Swollen legs and abdomen
  • Nausea and vomiting
  • Extreme fatigue

Is hep B contagious?

Yes, hepatitis B is contagious and can be spread from one infected person to another. It is transmitted through blood and body fluids, but can also live on surfaces for up to a week.

Complications of hepatitis B

Many hepatitis B infections resolve themselves (around 90% of adult infections and 50% of childhood infections, notes the CDC. However, the remaining infections are chronic and can lead to serious complications with the liver.

Hepatitis B and liver fibrosis

Liver fibrosis is a type of liver damage that results from inflammation and scarring. The scarring of the liver is called liver fibrosis. Liver fibrosis can lead to liver cirrhosis and eventually liver failure.

Hepatitis B and liver cirrhosis

A chronic hepatitis B infection can cause inflammation of the liver, which can lead to scarring, and the scarring can impair the function of the liver. This is a condition known as liver cirrhosis.

According to the Mayo Clinic, the scarring can impair the liver’s ability to function properly. Because blood cannot flow through the liver properly due to scarring, the liver can shrink and become hard (cirrhosis). This can lead to symptoms of advanced liver disease, liver failure, and death.

Hepatitis B and liver failure

Liver cirrhosis (scarring from inflammation) can cause the liver to not function properly. Since the liver is responsible for filtering waste and toxins from the body, this can lead to organ failure, reports the Mayo Clinic.

Hepatitis B and liver cancer

According to the Hepatitis B Organization, hepatitis B can sometimes alter the genes within liver cells. This can lead to liver cancer, even without having liver cirrhosis first.

People with hepatitis B should undergo liver cancer screenings regularly and frequently, because early detection is key for successful treatment.

Hepatitis B testing and diagnosis

Because many hepatitis B infections are asymptomatic, testing for hepatitis b is important for those who are at risk of contracting it.

How is hepatitis B diagnosed?

The most common way to test for hepatitis B is by getting a blood test. According to the Mayo Clinic, a blood test can detect a hepatitis B infection and can also determine if the infection is acute or chronic.

Ultrasound and liver biopsies are also used to confirm diagnosis and to determine any stages of liver damage.

Getting tested for hepatitis B

You can get tested for hepatitis B by visiting a healthcare provider at:

Who should get tested for hepatitis B?

Anyone who is exhibiting symptoms of hepatitis B should get tested, especially people who have hepatitis b risk factors.

Because hepatitis B is commonly spread from mother to infant during childbirth, pregnant women should consider a hepatitis B screening before delivery.

Treatments options for hepatitis B

Many hepatitis B infections go away on their own. Your healthcare provider can help determine if a hepatitis B infection is acute (new) or chronic (continuing for several months). Chronic hepatitis B infections may require treatment to ease symptoms and prevent complications.

Prevention before exposure

There is a vaccine for hepatitis B that has been FDA approved and recommended by the CDC since the early 1980’s.

The CDC recommends that the first hepatitis B vaccine be given within the first 24 hours after birth.

The hepatitis B vaccine is a series of 3 to 4 vaccines given over a period of time. The timing of the vaccines depends on the age of the person receiving them.

Prevention after exposure

According to the Mayo Clinic, there is an antibody injection that may help protect against hepatitis B if given within 24 hours of exposure. Because this antibody therapy offers only short-term protection, it is best to receive the hepatitis vaccine at the same time.

Treatment for acute hepatitis B

In many cases, acute hepatitis B will resolve on its own. According to the Mayo Clinic, your physician may recommend rest and monitoring of symptoms. Occasionally, symptoms may require a hospital stay or antiviral treatment.

Treatment for chronic hepatitis B

Most people with chronic hepatitis B will need medication for the rest of their lives, to help prevent liver damage and failure, according to the Mayo Clinic. Common treatments for chronic hepatitis B include:

  • antiviral medications
  • interferon injections
  • liver transplant

Antiviral medications for hepatitis B

There are several antiviral medications that are approved for use in hepatitis B patients. According to the Mayo Clinic, some common antiviral medications used for hepatitis B are:

According to the Mayo Clinic, these medications help fight the virus and slow its ability to damage the liver. Some healthcare providers may recommend the use of two antiviral medications or combining antiviral medication therapy with interferon injections.

Interferon injections for hepatitis B

According to the Mayo Clinic, interferon injections are used more often for young people who have hepatitis B and women with hepatitis B who wish to become pregnant.

Liver transplant for hepatitis B

People with advanced liver disease caused by chronic hepatitis B may qualify for a liver transplant.

Preventing hepatitis B

There is an FDA approved vaccine for hepatitis B, that is shown to be highly effective in preventing hepatitis B. For hepatitis B, the CDC says that the best treatment is prevention.

Currently, the CDC recommends everyone get the first hepatitis B vaccine within 24 hours of birth.

Frequently asked questions

  • How bad is it to get hepatitis B?

    Hepatitis B can lead to serious health complications, however, there are many treatment options available that help prevent complications. Hepatitis B is also preventable with a simple vaccine series.

  • What is the difference between hepatitis A, B and C?

    Hepatitis A commonly spreads through food, water, and the feces of infected individuals. It causes an acute inflammation of the liver that usually resolves itself. There is a vaccine available for hepatitis A.

    Hepatitis B is spread through blood and bodily fluids. Hepatitis B may resolve itself, or become a chronic condition that could lead to liver complications. A vaccine is available for prevention, and there are also treatment options available. 

    Hepatitis C is spread primarily through direct blood contact. There is no vaccine for prevention, however there are treatment options available.

  • What are important things to know about hepatitis B?

    It is important to know that hepatitis B is preventable through vaccination. The vaccine is safe, effective, and generally well-tolerated.

    It is also important to know that hepatitis B spreads through blood and bodily fluids from infected people. Many people do not know they are infected, so it is important to understand what may put you at high risk.

  • What other problems can hepatitis B cause?

    Hepatitis B is a virus that attacks the liver. According to the Mayo Clinic, It can cause problems with the liver, such as:

    • liver fibrosis
    • liver cirrhosis
    • liver cancer
    • liver failure
  • What is the prognosis for someone with chronic hepatitis B?

    For infants and young children, the Mayo Clinic says hepatitis B is more likely to become chronic and lead to serious complications. For adults, hepatitis B may resolve on its own, or be well-controlled with treatment.

    Vaccination helps to prevent most hepatitis B infections, notes the CDC.

  • Can Hepatitis B be spread through sexual contact?

    Although hepatitis B is not a common STI, it easily spreads through sexual contact. The CDC recommends that you should get tested for hepatitis B along with routine STI screenings.

  • Will a person who has hepatitis B ultimately need a liver transplant?

    Some people with chronic hepatitis B may qualify for liver transplant. However, this is very rare, notes the CDC.

  • Can you live a normal life with hepatitis B?

    Thanks to modern medicine, many people living with hepatitis B live healthy and active lives, reports the CDC. Several antiviral medications are available, as well as interferon injections.

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