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Home > Educational Resources > Liver Disease Info > Hepatitis B

Hepatitis B

Explore this section to learn more about hepatitis B, including a description of the disease and how it's diagnosed.

What is hepatitis B?

Hepatitis B is a disease of the liver that is caused by the hepatitis B virus, or HBV.

Most hepatitis B infections are short-term, or acute, and do not cause lasting health problems. In 5% of adult cases, however, hepatitis B becomes a long-term (chronic) condition. Chronic hepatitis B can lead to more serious liver diseases, including cirrhosis, liver failure and liver cancer. 15 to 25% of chronically infected persons will die from chronic liver disease.

Hepatitis B can be transmitted from a mother to her child during birth. Infants and children are much more likely than adults to develop chronic infection. 90 percent of children infected at birth develop chronic infection. 30 percent of children infected at age 1-5 years develop chronic infection.

1.4 million Americans are chronically infected with hepatitis B; it is responsible for 5,000 deaths annually.

A very small percent of people with acute hepatitis B may develop acute liver failure, a life-threatening condition that demands immediate medical attention.

What are the symptoms of hepatitis B?

Many people with acute hepatitis B, and most people with chronic hepatitis B, have no symptoms. When symptoms do occur they are often mild and may include fatigue, fever, loss of appetite, nausea, headache, muscle soreness, pain near the liver and jaundice (a yellowing of the skin and whites of the eyes).

Children are less likely than adults to exhibit symptoms of hepatitis B.

Because hepatitis B may produce no symptoms, many infected people do not know that they are infected.

What causes hepatitis B?

The hepatitis B virus passes from one person to another through body fluids, such as blood, semen and vaginal secretions. The hepatitis B virus can be spread from a mother to her child during birth. Other common causes of transmission include:

  • Sexual contact
  • Sharing needles among intravenous drug users
  • Sharing razors, toothbrushes or nail clippers
  • Being exposed to wounds, blood, or secretions from infected persons

How is hepatitis B diagnosed?

Hepatitis B is diagnosed with a blood test. The test may include several markers of HBV infection that show whether you a) are immune to hepatitis B (protected), b) have never been exposed to hepatitis B, or c) are infected with hepatitis B. If the results are not conclusive, your doctor may choose to conduct additional tests.

The hepatitis B blood test is not included in routine blood tests. If you are at risk for hepatitis B, or if you are concerned about hepatitis B, don’t hesitate to talk to your doctor about testing and vaccination.

Some people learn they have the disease or have had it in the past when they volunteer to donate blood. All blood donation centers test for current and past hepatitis B infections and reject anyone who was ever infected.

How is hepatitis B treated?

Medicines are not used to treat acute hepatitis B because the disease usually goes away on its own.

If you have been diagnosed with acute hepatitis B you must see your doctor for follow-up blood tests to make sure your body clears the virus. After the virus has been cleared from your body, you will be protected for life and will never get hepatitis B again.

If you have acute hepatitis B, you should reduce the pace of your daily activities to match any loss of energy. A balanced diet with plenty of fluids is also helpful. Your liver’s ability to break down drugs is weakened while you have hepatitis B and alcohol can cause further damage to your liver. Therefore you should not take any drug or herbal supplement unless approved by your doctor, and avoid alcohol.

Some people with chronic hepatitis B may need antiviral medications to suppress the virus and prevent further damage to their liver. If you have chronic hepatitis B, you should see a doctor even if you have no symptoms. Your doctor will order blood tests to check if you have high or low levels of the virus and if you have mild or severe liver damage, which will help determine if you should take antiviral medications. FDA-approved treatments for hepatitis B include interferon alfa-2b and peginterferon alfa-2a which are given as injections, and lamivudine, adefovir dipivoxil, and entecavir which are given as pills.

Everyone with chronic hepatitis B should see a doctor and have blood tests regularly to monitor the level of the virus and severity of liver damage. Your doctor may also order tests to see if you have early-stage liver cancer.

How do I talk to my doctor about hepatitis B?

If you are getting tested for hepatitis B, ask your doctor to explain the test results to you and tell you what they mean. Make sure you understand whether you have chronic hepatitis B infection, were infected in the past or have never been infected.

If you are diagnosed with chronic hepatitis B, ask your doctor:

  • “Do I have high or low virus level?”
  • “Do I have mild or severe liver damage?”
  • “What are my chances of developing cirrhosis or liver cancer?”
  • “Do I need to have my family tested?”
  • “Do I need to receive treatment for hepatitis B?”
  • “How will treatment help me?”
  • “What treatment do you recommend? What do I need to know about my treatment?”
  • “How long will I need to be treated? When can I expect to see the results from the treatment?”
  • “How will you assess whether the treatment is working for me?”
  • “What should I do if I have side effects? Is there anything I can take to help the side effects go away?”
  • “If I do not need to receive treatment now, how often should I be tested?”
  • “Should I take any special precautions to avoid infecting others?”

If I have chronic hepatitis B, what can I do to help keep myself and others healthy?

It is recommended that anyone with hepatitis B should tell their doctors and dentist. You should also:

  • Be under the care of a doctor who specializes in the liver.
  • Stay on any prescribed medications and keep all your medical appointments.
  • Get the hepatitis A vaccination to protect yourself from another liver infection.
  • Maintain a healthy lifestyle by eating nutritious meals, getting exercise, resting when you feel tired and avoiding alcohol and illegal drugs.
  • Use only drugs and supplements that your doctor has approved.
  • Take precautions to avoid spreading the disease through the exchange of body fluids with sexual partners.
  • Avoid spreading your blood to others. Don’t share razors, toothbrushes or nail clippers.

Who is at risk for hepatitis B?

Anyone who is exposed to the blood or body fluids of an infected person is at risk of getting hepatitis B. In addition, immigrants from areas where hepatitis B is common, such as Central and Southeast Asia, Africa, and East Europe, are at risk of having chronic hepatitis infection. Children of immigrants from these regions are also at risk because the virus can be passed from mother to child during birth or from other household members.

You may also be at risk of getting hepatitis B if you:

  • Are exposed to blood or bodily secretions on the job, as a first aid or emergency worker, firefighter, mortician, embalmer, police officer or health care worker
  • Live in the same household with an infected person
  • Have unprotected sex with an infected person or have more than one sexual partner
  • Inject illicit drugs
  • Have hemophilia
  • Work or are a patient in a health care or long-term care facility
  • Work or are incarcerated in a prison
  • Get a tattoo in unsterile conditions
  • Stay for more than a few months in countries where hepatitis B is common
  • Are a hemodialysis patient

What is the best way to prevent hepatitis B?

Vaccination is the best way to prevent hepatitis B because it gives you long term immunity. The hepatitis B vaccine is given in three doses. The first two doses are given a month apart; the final dose is given about six months later. Vaccination is recommended for:

  • All newborns, infants, children and teenagers
  • Health care and emergency workers
  • Hemodialysis patients
  • Patients with chronic liver disease
  • Military personnel
  • Morticians and embalmers
  • Patients and staff at institutions for the developmentally challenged
  • Prison inmates
  • People with multiple sexual partners
  • Men who have sex with men
  • Injection drug users
  • Sexual partners and household members of people with hepatitis B
  • International travelers who expect to have close contact with residents in countries or regions where there is a high rate of hepatitis B infection
  • Members of ethnic or racial groups with a high rate of hepatitis B infection (including Asian Americans, African Americans, Latino Americans, Native Americans and Alaskan Natives)

Page updated: September 28th, 2007