Hepatitis B

What is hepatitis B?

Hepatitis is a redness and swelling (inflammation) of the liver. It sometimes causes permanent liver damage.

There are several types of hepatitis. In hepatitis B, the liver is infected with the hepatitis B virus. This causes inflammation. The liver isn’t able to work the way it should.

The liver is a large organ that lies up under the ribs on the right side of your belly (abdomen). It helps filter waste from your body, makes a fluid called bile to help digest food, and stores sugar that your body uses for energy. It also makes many proteins that are needed in the body.

In the U.S., hepatitis B is one of the most common diseases that can be prevented with a vaccine.

Hepatitis B can be short-term (acute) or long-term (chronic). It tends to become chronic most often in infants and young children, and less often in people infected as adults.

• Acute hepatitis B. This is a brief infection (6 months or less) that goes away because the body gets rid of the virus.

• Chronic hepatitis B. This is a long-lasting infection that happens when your body can’t get rid of the virus. It causes long-term liver damage.

What causes hepatitis B?

Hepatitis B is caused by infection with the hepatitis B virus. People pass the hepatitis B virus to each other. This happens when you come into contact with another person’s infected:  

• Blood

• Semen

• Vaginal secretions

• Saliva

Common ways this virus is spread are through:

• Needle sticks

• Sharp instruments

• Shared razors and toothbrushes

• Unprotected sex with an infected person

• Sharing drug supplies

Babies may also get the disease if their mother has the virus. Infected children can spread the virus to other children if they play together often and body fluids are shared. For example, a child comes into contact with blood or open, draining sores from an infected child.

Body fluids need to come in contact to spread the virus. So just playing next to a friend will not give someone hepatitis B. A person can't get hepatitis B from:

• Sitting next to an infected person

• Hugging an infected person

• Shaking hands or holding hands with an infected person

• Drinking water or eating food

• Being sneezed or coughed on by an infected person

Who is at risk for hepatitis B?

Anyone can get hepatitis B by coming into contact with the blood or body fluids of someone who is infected with hepatitis B.

Some people are at higher risk for getting hepatitis B. They include:

• Children born to mothers who have hepatitis B. Pregnant women should be tested for hepatitis B.

• People from Asian and Pacific Island nations

• People living in long-term care facilities or who are disabled

• People living in households where someone is infected with the virus

• People who have a blood-clotting disorder, such as hemophilia

• People who need dialysis for kidney failure

• People who use IV (intravenous) drugs

• People who have unprotected sex, especially if they have many sex partners

• People who have a job where they are in contact with human blood, body fluids, or needles

• People who work or live in a prison

• People who had blood transfusions, blood products, or organ transplants before the early 1990s

• People taking medicines that weaken (suppress) the body’s infection-fighting system (immune system)

• People with HIV (human immunodeficiency virus) or hepatitis C infections

What are the symptoms of hepatitis B?

Hepatitis B has a wide range of symptoms. It may be mild, without symptoms, or it may cause chronic hepatitis. In some cases, hepatitis B can lead to liver failure and death.

Each person’s symptoms may vary. The most common symptoms of hepatitis B include:

• Loss of appetite

• Nausea and vomiting

• Extreme tiredness (fatigue)

• Fever

• Muscle soreness

• Joint pain

• Yellowing of the skin and eyes (jaundice)

• Dark yellow urine

• Clay-colored or gray-colored stools

• Belly (abdominal) pain

• Diarrhea

• Easy bleeding and bruising

• Confusion

• Swollen belly from fluid

The symptoms of hepatitis B may look like other health problems. Always see your healthcare provider to be sure.

How is hepatitis B diagnosed?

To see if you have hepatitis B, your healthcare provider will give you a physical exam and do a blood test.

If your healthcare provider suspects chronic hepatitis B, they may take a small tissue sample (biopsy) from your liver with a needle. These samples are checked under a microscope to find out the type of liver disease and how bad it is. An ultrasound test is usually done as well to see if the liver looks very diseased. 

How is hepatitis B treated?

Hepatitis B is not treated unless it becomes a long-term (chronic) infection. Then medicines are used to try to slow down or stop the virus from damaging the liver. Most people get medicines they can take by mouth (orally). But some people get an injection. The decision to treat is complicated and based on many things. These include test results and how advanced your disease is.

Your symptoms will be closely watched and managed as needed. If severe liver damage occurs, you may need a liver transplant.

There is no cure for hepatitis B. Treatment is helpful to decrease the amount of virus in your blood and decrease risk of complications. 

What are possible complications of hepatitis B?

Long-term or chronic hepatitis B can cause severe liver damage. The most severe liver damage is called cirrhosis. The liver stops working correctly. This could lead to the need for a liver transplant.

Liver failure can lead to death.

The risk of liver cancer is higher in people with hepatitis B.

What can I do to prevent hepatitis B?

A vaccine is available to prevent hepatitis B. The 3-dose vaccine is advised for all babies and unvaccinated children age 18 and younger. For adults, it's given either as 2 shots (injections) at least 4 weeks apart or as 3 shots over 6 months. The vaccine is advised for any adult who wants to be protected and for adults who are at risk for the infection. If you've been exposed to hepatitis B very recently, your provider may give you a shot (injection) of hepatitis B immune globulin.

You can protect yourself and others from hepatitis B by:

• Using condoms during sex

• Making sure any tattoos or body piercings are done with tools that have been cleaned correctly and don't have any germs (sterile)

• Not sharing needles and other drug supplies

• Not sharing toothbrushes or razors

• Not touching another person’s blood or body fluids unless you wear gloves

Key points about hepatitis B

• Hepatitis B is a redness and swelling (inflammation) of the liver. It sometimes causes permanent liver damage.

• Hepatitis B is caused by infection with the hepatitis B virus.

• People pass the hepatitis B virus to each other through infected blood and body fluids such as semen, vaginal secretions, and saliva.

• You can protect yourself by using condoms during sex, not sharing needles or drug equipment, and not sharing toothbrushes or razors.

• A vaccine is available to prevent hepatitis B.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.