Hepatitis B is the liver infection caused by hepatitis B virus (HBV). For many people, hepatitis B is a short-term illness. For others, it can become a long-term, chronic infection that can lead to serious, even life-threatening health issues like cirrhosis or liver cancer. Risk for chronic infection is related to age at infection: about 90% of infants with hepatitis B go on to develop chronic infection, whereas only 2%–6% of people who get hepatitis B as adults become chronically infected. The best way to prevent hepatitis B is to get vaccinated.
Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis — a condition that permanently scars of the liver. If you’re infected, taking certain precautions can help prevent spreading the virus to others.
Symptoms
Signs and symptoms of hepatitis B range from mild to severe. They usually appear about one to four months after you’ve been infected, although you could see them as early as two weeks post-infection. Some people, usually young children, may not have any symptoms.
Hepatitis B signs and symptoms may include:
- Jaundice (Your skin or the whites of the eyes turn yellow, and your pee turns brown or orange.)
- Light-colored poop
- Fever
- Fatigue that persists for weeks or months
- Stomach trouble like loss of appetite, nausea, and vomiting
- Belly pain
- Joint pain
- Loss of appetite
Symptoms of long-term (chronic) hepatitis B infection don’t always show up, either. If they do, they may be like those of short-term (acute) infection.
If you think you have signs or symptoms of hepatitis B, contact your doctor.
Causes
Hepatitis B infection is caused by the hepatitis B virus (HBV). The virus is passed from person to person through blood, semen or other body fluids. It does not spread by sneezing or coughing.
Common ways that HBV can spread are:
- Sexual contact – You may get hepatitis B if you have unprotected sex with someone who is infected. The virus can pass to you if the person’s blood, saliva, semen or vaginal secretions enter your body.
- Sharing of needles – HBV easily spreads through needles and syringes contaminated with infected blood.
- Accidental needle sticks – Hepatitis B is a concern for health care workers and anyone else who comes in contact with human blood.
- Mother to child – Pregnant women infected with HBV can pass the virus to their babies during childbirth. However, the newborn can be vaccinated to avoid getting infected in almost all cases. Talk to your doctor about being tested for hepatitis B if you are pregnant or want to become pregnant.
Hepatitis B doesn’t spread through kissing, food or water, shared utensils, coughing or sneezing, or through touch.
Hepatitis B Diagnosis
If your doctor thinks you may have it, they’ll give you a complete physical exam. They will test your blood to see if your liver is inflamed. If you have hepatitis B symptoms and high levels of liver enzymes, you’ll be tested for:
- Hepatitis B surface antigen and antibody (HBsAg) – Antigens are proteins on the hepatitis B virus. Antibodies are proteins made by your immune cells. They show up in your blood between 1 and 10 weeks after exposure. If you recover, they go away after 4 to 6 months. If they’re still there after 6 months, your condition is chronic.
- Hepatitis B surface antibody (anti-HBs) – These show up after HBsAg disappears. They’re what make you immune to hepatitis B for the rest of your life.
If your disease becomes chronic, your doctor might take a tissue sample from your liver, called a biopsy. This will tell them how severe your case is. You might also get a liver ultrasound to check on how much liver damage there is.
Risk factors
Hepatitis B spreads through contact with blood, semen or other body fluids from an infected person. Your risk of hepatitis B infection increases if you:
- Have unprotected sex with multiple sex partners or with someone who’s infected with HBV
- Share needles during IV drug use
- Are a man who has sex with other men
- Live with someone who has a chronic HBV infection
- Are an infant born to an infected mother
- Have a job that exposes you to human blood
- Travel to regions with high infection rates of HBV, such as Asia, the Pacific Islands, Africa and Eastern Europe.
Prevention
The hepatitis B vaccine is typically given as three or four injections over six months. You can’t get hepatitis B from the vaccine.
The hepatitis B vaccine is recommended for:
- Newborns
- Children and adolescents not vaccinated at birth
- Those who work or live in a center for people who are developmentally disabled
- People who live with someone who has hepatitis B
- Health care workers, emergency workers and other people who come into contact with blood
- Anyone who has a sexually transmitted infection, including HIV
- Men who have sex with men
- People who have multiple sexual partners
- Sexual partners of someone who has hepatitis B
- People who inject illegal drugs or share needles and syringes
- People with chronic liver disease
- People with end-stage kidney disease
- Travelers planning to go to an area of the world with a high hepatitis B infection rate
Hepatitis B Treatment
If you think you’ve been exposed to the virus, get to a doctor as soon as possible. The earlier you get treatment, the better. They’ll give you a vaccine and a shot of hepatitis B immune globulin. This protein boosts your immune system and helps it fight off the infection.
If you do get sick, your doctor may put you on bed rest to help you get better faster.
You’ll have to give up things that can hurt your liver, like alcohol and acetaminophen. Check with your doctor before taking any other drugs, herbal treatments, or supplements. Some of them can harm this organ, too. Also, eat a healthy diet.
If the infection goes away, the doctor will tell you you’re an inactive carrier. That means there’s no more virus in your body, but antibody tests will show that you had hepatitis B in the past.
If the infection is active for longer than 6 months, your doctor will tell you that you have chronic active hepatitis B. They may prescribe some of these medications to treat it:
- Entecavir (Baraclude) – This is the newest drug for hepatitis B. You can take it as a liquid or tablet.
- Tenofovir (Viread) – This drug comes as a powder or tablet. If you take it, your doctor will check often to make sure it doesn’t hurt your kidneys.
- Lamivudine (3tc, Epivir A/F, Epivir HBV, Heptovir) – It comes as a liquid or tablet you take once a day. Most people don’t have a problem with it. But if you take it for a long time, the virus might stop responding to the drug.
- Adefovir dipivoxil (Hepsera) – This drug, which you take as a tablet, works well for people who don’t respond to lamivudine. High doses can cause kidney problems.
- Interferon alfa (Intron A, Roferon A, Sylatron) – This medicine boosts your immune system. You take it as a shot for at least 6 months. It doesn’t cure the disease. It treats liver inflammation. Long-acting interferon, peginterferon alfa2a, can also help. But this drug can make you feel bad all over or depressed, and it can and zap your appetite. It also lowers your white blood cell count, which makes it harder to fight off infection.
- Telbivudine (Tyzeka) – is an antiviral medication. Resistance to this medication is common.
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