Hepatitis B

Hepatitis B is one of several types of hepatitis (liver inflammation). Many acute cases of hepatitis B get better on their own, but chronic hepatitis B often requires treatment with medications. Among the ways in which the hepatitis B virus can be spread are contact with infected blood and sex with an infected person. The hepatitis B virus can also be transmitted from an infected mother to her child during childbirth. The best way to prevent hepatitis B is through the hepatitis B vaccine.

 

What Is Hepatitis B?

Hepatitis B is a disease of the liver caused by a virus (specifically, the hepatitis B virus). Most people who get hepatitis B can get rid of the virus on their own, but others can develop chronic (or life-long) hepatitis B.
 
Besides hepatitis B, there are several other types of viral hepatitis, including hepatitis A, C, D, E, and G.
 

Cause of Hepatitis B

The cause of hepatitis B is an infection with the hepatitis B virus. The hepatitis B virus is a DNA virus that belongs to the genus Orthohepadnavirus of the Hepadnaviridae family.
 
(Click Hepatitis B Causes for more information about the cause of hepatitis B.)
 

Acute Versus Chronic Hepatitis B

There are two types of hepatitis B -- acute (recently acquired) and chronic (life-long).
 For most people with acute hepatitis B, symptoms gradually get better within a couple of months. These people with have no long-lasting liver damage and will recover completely.
 
For some people, the body is not able to completely get rid of the virus. These people end up having a long-term liver infection. This is called chronic hepatitis B. People with chronic hepatitis B can infect others and are at an increased risk of serious liver disease, including cirrhosis and liver cancer. In the United States, an estimated 1.25 million people are chronically infected with HBV.
 

Spreading Hepatitis B

The hepatitis B virus is spread through infected bodily fluids. Among the bodily fluids that can transmit the hepatitis B virus are infected blood and blood products. Hepatitis B is also spread through contact with other infected bodily fluids, such as semen, vaginal fluids, or saliva.
 
Casual contact, as in the usual office, factory, or school setting, does not spread the virus. A person cannot get hepatitis B from a kiss or other normal everyday activities, such as hugging or shaking hands.
 
(Click Hepatitis B Transmission for more information on how hepatitis B is spread.)
 

Who's at Risk for Hepatitis B?

Some of the people who are at risk of developing hepatitis B include:
 
  • Those who have sex with an infected person
  • Men who have sex with men
  • Intravenous drug users
  • Children of immigrants from disease-endemic areas
  • Infants born to infected mothers
  • People who live with an infected person
  • Healthcare workers
  • Hemodialysis patients
  • People who received a transfusion of blood or blood products before July 1992
  • People who received clotting factors made before 1987
  • International travelers.
     

Incubation Period for Hepatitis B

Following hepatitis B transmission, a person does not immediately become sick. Once the hepatitis B virus enters the body, it travels to the liver, where it begins to multiply.
 
After 30 to 180 days, hepatitis B symptoms can begin. This period between hepatitis B transmission and the start of hepatitis B signs and symptoms is called the "hepatitis B incubation period."
 
(Click Hepatitis B Incubation Period for more information.)
 

Symptoms of Hepatitis B

Many people who get hepatitis B will not have any symptoms. This is especially true of children. If people do have symptoms of hepatitis B, they may start abruptly and include the following:
 
  • Yellowing of the skin or eyes (also known as jaundice)
  • Feeling very tired
  • Abdominal pain (or stomach pain)
  • Not feeling very hungry
  • Dark urine
  • Nausea
  • Diarrhea
  • Muscle pain
  • Joint pain
  • A low-grade fever.
     
In a number of people, these symptoms may be confused with stomach flu symptoms, especially in the early stages of the illness.
 
(Click Hepatitis B Symptoms for more information on the possible impact of a hepatitis B virus infection.)
 

Hepatitis B Contagious Period

A person is contagious during the hepatitis B incubation period. A person who is infected with hepatitis B begins to be contagious early in the incubation period. About one-half of people remain contagious for up to two months after hepatitis B symptoms begin. The remainder of people who do not develop chronic hepatitis B will remain contagious for up to 15 weeks after symptoms begin. If a person develops chronic hepatitis B, they will remain contagious indefinitely.
 

Hepatitis B Diagnosis

In order to make a hepatitis B diagnosis, the doctor will ask the patient a number of questions and perform a physical exam to look for signs and symptoms of hepatitis B.
 
If the doctor suspects hepatitis B, he or she will order certain tests to help diagnose the disease. Some of these tests will look for high levels of liver enzymes. Other tests will look for antibodies the body has made against the hepatitis B virus.
 
(Click Diagnosing Hepatitis B or Hepatitis B Testing for more information about making a hepatitis B diagnosis.)
 

Treatment for Hepatitis B

There are no specific medicines that can cure acute hepatitis B (see Cure for Hepatitis B). Therefore, treatment for acute hepatitis B is focused on dealing with any symptoms or complications that may occur. This is known as supportive care. Even without specialized treatment for acute hepatitis B, most people recover completely within a few months.
 
For people with chronic hepatitis B, specific medicines are available to help slow down liver damage and possibly prevent complications of hepatitis B. Some of these hepatitis B medications include:
 
  • Alpha interferon
  • Pegylated alpha interferon
  • Lamivudine (Epivir-HBV®)
  • Adeforvir dipivoxil (Hepsera®)
  • Entecavir (Baraclude®)
  • Telbivudine (Tyzeka®).
     
However, medicines are not right for everyone with chronic hepatitis B.
 
(Click Hepatitis B Treatment for more information about the treatment of hepatitis B. Click Hepatitis B Diet for information about what to eat if you have hepatitis B.)
 

Hepatitis B Prognosis

While there is no hepatitis B cure, most people infected with the hepatitis B virus get well without any long-term problems.
 
Chronic infection with HBV means that you have a long-term HBV infection; your body did not get rid of the virus when you were first infected with HBV. The risk of progressing to chronic hepatitis B is age-dependent:
 
  • Up to 90 percent of infants
  • 30 percent of children ages one to five years
  • 2 percent to 6 percent of people over five years of age.
     
Hepatitis B can be serious for older people and people who already have liver disease. Death is possible, although rare (occurring in about 1 percent of people).
 

Preventing Hepatitis B

The best cure for hepatitis B is preventing it in the first place. Hepatitis B prevention is best accomplished with the hepatitis B vaccine, which is given as a shot. Avoiding high-risk situations can also help prevent hepatitis B.
 
(Click Hepatitis B Prevention for more information about preventing hepatitis B.)
 

Statistics on Hepatitis B

Following are some key hepatitis B statistics:
 
  • The number of new hepatitis B infections per year has declined from an average of 260,000 in the 1980s to about 73,000 in 2003.

 

  • The highest rate of hepatitis B occurs in 20- to 49-year-olds.

 

  • The greatest decline in hepatitis B has occurred among children and adolescents due to routine hepatitis B vaccination.

 

  • About 1.25 million Americans are estimated to be chronically infected with hepatitis B. Of these people, 20 to 30 percent acquired their infection in childhood.
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD