Hepatitis B

Hepatitis B is a viral infection that causes inflammation in your liver. It’s the most common liver infection in the world. You may have symptoms like belly pain or fever, but some people don’t get symptoms at all. You may also develop symptoms of liver disease.

Hepatitis B spreads through contact with the bodily fluids of someone infected with the virus. For instance, it can be sexually transmitted or by sharing needles with someone who has it. Hepatitis B is a serious infection because it can lead to complications like liver failure.

There’s no cure for hepatitis B. But you can manage the condition with medications that make the virus inactive. Hepatitis B vaccination can help prevent the infection.

Types of hepatitis B

There are two main types:

• Acute hepatitis B: Acute hepatitis B is a short-term illness that may not cause symptoms. Sometimes, it goes away without treatment.
• Chronic hepatitis B: Chronic hepatitis B is a long-term infection. It can lead to complications like cirrhosis and liver failure.

Hepatitis B symptoms

You may not have symptoms or signs of hepatitis B. If they do appear, they may include:

• Abdominal (belly) pain
• Fatigue and weakness
• Fever
• Joint pain
• Loss of appetite
• Nausea and vomiting

You may also have symptoms of liver disease. These can include:

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

How do you get hepatitis B?

Hepatitis B transmission occurs when you’re exposed to the bodily fluids of someone who has the virus. These include:

• Amniotic fluid
• Blood
• Menstrual fluid
• Saliva
• Semen
• Vaginal fluid

Hepatitis B is mainly transmitted through:

• Unprotected sexual contact with someone infected with the virus
• Sharing needles or syringes with someone who has it
• Getting cut with a contaminated medical instrument, like a scalpel

Is hepatitis B contagious?

Yes, 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 is lower. Your healthcare provider can do blood tests to find out if you have an active or inactive virus.

Risk factors

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

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

Is there a vaccine for hepatitis B?

Yes, and getting vaccinated is the most effective way to prevent an infection. It takes three doses of the vaccine before you’re completely protected. You’ll receive a series of shots over six months. In the meantime, to reduce your risk, you can:

• 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.

Complications

Acute and chronic hepatitis B can lead to complications like:

• Hepatitis D: Another type of hepatitis that you can get if you have hepatitis B
• Reactivated hepatitis B: Acute hepatitis B that comes back if you take immunosuppressants or stop the medication
• Cirrhosis: Scar tissue that builds up in your liver
• Acute liver failure: Liver failure that happens very quickly
• Chronic liver failure: Liver failure that happens over time
• Liver cancer: A serious cancer that’s most often caused by chronic hepatitis B

How is hepatitis B diagnosed?

A healthcare provider will ask you about your symptoms and do a physical exam. They’ll ask if you have a biological family history of liver disease. They may also 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. But they’re only asking them to understand your situation so they can help you.

Hepatitis B testing

Your healthcare provider may do:

• Blood tests, to check if you have acute or chronic hepatitis B
• Imaging tests, like elastography, to see if you have scar tissue in your liver
• Liver biopsy, if your provider wants more information than blood and imaging tests can provide

Can hepatitis B be cured?

Hepatitis B doesn’t have a cure. But certain medications can make the virus inactive. Inactive hepatitis B means you have the virus, but it can’t spread.

Hepatitis B treatments

Treatment for hepatitis B depends on your condition.

Prophylactic treatment

Prophylactic treatment is when your healthcare provider gives you medication to prevent a disease. Your provider may prescribe it if you were exposed to the virus within the past 24 hours. Medications include:

• Hepatitis B vaccination: A series of hepatitis B vaccinations
• Hepatitis B immune globulin (HBIG): A medication that 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 to 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 overall health. Treatment options are:

• Surveillance: Your provider will keep an eye on your overall health with follow-up appointments every three to six months. They may do blood and imaging tests to look for signs of the virus.
• Medication: Your provider may prescribe hepatitis B medications, like antivirals or immunomodulators. They reduce the risk that you’ll spread hepatitis B to someone else. You’ll take these medications 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.

Is there anything I can do to feel better?

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

• 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.
• Get 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. You may want to get vaccinated for hepatitis A. Also, get tested for hepatitis C and get treatment if you have it.