Hepatitis B

What is hepatitis B?

Hepatitis B is a viral infection that causes inflammation in your liver. It can be a brief illness that may not cause symptoms and goes away without treatment. This is acute hepatitis B. But some people have a chronic (long-term) form of the virus. It can lead to cirrhosis and liver failure.

There’s no cure for hepatitis B. But there are medications that can make the virus inactive. Inactive hepatitis B means you have the virus. But inactive viruses can’t spread.

How common is hepatitis B infection?

Hepatitis B is the most common liver infection in the world. The World Health Organization (WHO) estimates that 254 million people worldwide are living with hepatitis B. The U.S. Centers for Disease Control and Prevention (CDC) estimates that approximately 14,000 people in the U.S. have acute hepatitis. The CDC also estimates that 640,000 people in the U.S. have chronic hepatitis B.

What are the symptoms of hepatitis B infection?

You can have hepatitis B without having symptoms. If you do, symptoms may include:

• Abdominal pain
• Fatigue
• Fever
• Joint pain
• Loss of appetite
• Nausea and vomiting
• Weakness

You may also have symptoms of liver disease, including:

• Dark-colored pee
• Light or clay-colored poop
• Swelling from fluid in your belly or arms and legs
• Yellowing of your skin and the whites of your eyes from jaundice

What causes hepatitis B?

You get hepatitis B if you’re exposed to bodily fluids from someone who has the virus. This can be amniotic fluid, blood, menstrual fluid, saliva, semen or vaginal fluid. Exposure to bodily fluids can happen if you:

• Share needles or syringes with someone who has the virus
• Have unprotected sex with someone who has it
• Get stuck with a contaminated medical instrument like a scalpel

Risk factors for hepatitis B

Anyone can get hepatitis B. But you may have increased risk if you:

• Have sexually transmitted infections like HIV
• Take immunosuppressants to keep your immune system from attacking healthy tissue by mistake
• Are receiving dialysis
• Have another type of liver disease

How long are you contagious with hepatitis B?

You’re contagious as long as the virus is active in your body. For example, acute hepatitis B can last for up to six months. You can spread the virus that entire time. If you have active chronic hepatitis B, you’ll be contagious for the rest of your life. If you have inactive chronic hepatitis B, the risk would be lower. Your healthcare provider can do blood tests to find out if you have an active or inactive virus.

What are the possible complications of hepatitis B infection?

Acute and chronic hepatitis B may cause complications like:

• Acute liver failure. This is liver failure that happens very quickly. People with acute hepatitis B have an increased risk of acute liver failure.
• Chronic liver failure. Chronic hepatitis B can lead to liver failure that happens over time.
• Cirrhosis. Cirrhosis happens when scar tissue builds up in your liver. Your liver makes scar tissue when it repairs damage. The more damage, the more scar tissue.
• Hepatitis D. This is another type of hepatitis that you can get if you have hepatitis B.
• Liver cancer. Chronic hepatitis B is the leading cause of liver cancer.
• Reactivated hepatitis B. This is acute hepatitis B that comes back if you take immunosuppressants or stop the medication.

How is hepatitis B diagnosed?

A healthcare provider will ask you about your symptoms and do a physical examination. They’ll ask if you have a family history of liver disease. They may ask if:

• Your work exposes you to the virus
• You use intravenous (IV) drugs
• You have unprotected sex with people who may have hepatitis B

You may feel hesitant about answering these very personal questions. Your provider understands they may be hard questions to answer. But they’re only asking them to understand your situation so they can help you.

What tests diagnose hepatitis B?

Your healthcare provider will do:

• Blood tests that show if you have acute or chronic hepatitis B
• Imaging tests like elastography that can detect if you have cirrhosis (scar tissue in your liver)
• Liver biopsy if your provider wants more information about your liver than blood and imaging tests provide

What are hepatitis B treatments?

Your treatment will be different depending on your situation. Treatments may include:

Prophylactic treatment

Prophylactic treatment is when healthcare providers give you medication to prevent a disease. Providers prescribe prophylactic treatment if you were exposed to the virus within the past 24 hours. Medications include:

• Hepatitis B vaccination. This is a series of hepatitis B vaccinations.
• Hepatitis B immune globulin (HBIG). This medication contains antibodies that protect your body from viruses and bacteria.

Acute hepatitis B treatment

There’s no specific treatment for acute hepatitis B. Your provider may give you IV fluids if you throw up a lot and have diarrhea. The fluids will prevent dehydration. Dehydration is when you lose so much bodily fluid that your body can’t work as it should.

Chronic hepatitis B treatment

Chronic hepatitis B treatment varies depending on your symptoms and your overall health. Treatment options are:

• Surveillance. This may sound scary. But it just means your healthcare provider is keeping an eye on your overall health. You’ll have follow-up appointments every three to six months. Your provider may do blood and imaging tests to look for signs of the virus.
• Medication. Your provider may prescribe antiviral drugs or immunomodulators. These drugs reduce the risk that you’ll spread hepatitis B to someone else. You’ll take these drugs for the rest of your life.
• Surgery. Your provider may recommend surgery to remove part of your liver if hepatitis B causes cancer. You may need a liver transplant if you have surgery to remove your whole liver.

How can I reduce my risk of hepatitis B infection?

Vaccination is the best way to prevent an infection. It takes three doses of the hepatitis B vaccine before you’re completely protected. You’ll receive shots over six months. In the meantime, things you can do to reduce your risk include:

• Practice safe sex. Use a latex or polyurethane condom if you don’t know whether your partner has the virus.
• Don’t share personal items. You can get hepatitis B from exposure to infected blood on personal items like a toothbrush or razor.
• Practice safe needle use. If you use intravenous drugs, don’t share needles or syringes with anyone.

How can I prevent transmitting the infection to others?

Your first step is to find out if you have the virus. The CDC recommends that everyone aged 18 and older have a hepatitis B test. If you have acute hepatitis B, you should stay home from work and not spend time with others until your symptoms go away. If you have the chronic form of the disease, your healthcare provider may prescribe medication that reduces the risk you’ll spread the virus.

How should I take care of myself while living with chronic hepatitis B?

Chronic hepatitis B symptoms can change over time. One way you can take care of yourself is to stay connected with your healthcare team. Other suggestions include:

• Avoid alcohol. Toxic substances can build up in your liver if you regularly drink more than 1.5 ounces to 2 ounces of alcohol a day.
• Eat well. Fill your plate with lean protein, fruits and vegetables. The Mediterranean diet is an example of a food plan that supports liver health.
• Look for support. It can help to spend time with people who know what you’re going through.
• Take care before taking new medicines. That includes herbal medicines. Some herbs may damage your liver or not mix with your other medications.
• Protect yourself from other liver infections. If you haven’t been vaccinated for hepatitis A, get the vaccine. Get tested for hepatitis C and get treatment if you have it. Hepatitis C is curable.