Hepatitis is inflammation of the liver. Hepatitis B is hepatitis caused by the hepatitis B virus.
Hepatitis B virus spreads through contact with infected blood. Specifically, hepatitis B may be spread through:
- Direct contact with the blood of an infected person
- Unprotected sexual activity with an infected person
- Needle sharing among intravenous drug users
- Sharing razors or other personal items with an infected person
- Being pierced or tattooed with contaminated instruments
- Blood transfusions (extremely rare in the United States because of improved testing)
- Childbirth, when the virus is passed from mother to child
Immunization with the hepatitis B vaccine has reduced the number of hepatitis B cases in the United States.
The hepatitis B virus can cause temporary or long-term hepatitis. The initial infection with the virus may not even cause symptoms. When it does cause hepatitis symptoms (acute hepatitis), most people with acute hepatitis B will clear the virus from their systems.
But a minority of people will develop a long-term infection. This is called chronic hepatitis. In chronic hepatitis, the symptoms of hepatitis disappear then come back later. People with chronic hepatitis remain infectious. They can pass on the virus to others.
Some people are not able to rid their body of the infection. But they do not have any symptoms of disease. These people are called carriers. They can pass the infection to others.
The initial symptoms of acute hepatitis B vary. They can include:
- Loss of appetite
- Weight loss
- Abdominal pain
- Sleep disturbance
- Loss of sex drive
These symptoms may be followed by jaundice. Jaundice is a yellowing of the eyes and skin, and a darkening of the urine.
Most people recover from acute hepatitis. They are no longer infected with the virus when their illness ends.
However, about 1 in 10 adults may develop chronic hepatitis. They remain infected by the virus, can develop chronic liver disease, and can pass the virus to other people.
People with chronic hepatitis may be free of symptoms for long periods. But symptoms eventually reappear. Symptoms, when they do occur, may include:
- Jaundice (yellow color of the skin and eyes)
- An ill feeling
- Decreased appetite
- Aching joints
A small number of people with chronic hepatitis develop liver cirrhosis. This is a scarring of the liver that results in poor liver function. They may develop symptoms of advanced liver disease, including:
- Fluid accumulation inside the abdomen
- Swelling of the legs
- Gastrointestinal bleeding
People with hepatitis B who develop cirrhosis are at risk of developing liver cancer.
Your doctor will ask about any potential exposures to hepatitis B. This includes any illegal drug use or unprotected sexual activity. Your doctor will examine your skin, eyes and abdomen for evidence of fluid accumulation. He or she will estimate the size of your liver.
Your doctor will order blood tests. These check your liver function and can spot liver damage.
Blood tests can also confirm a hepatitis B diagnosis. They detect the presence and amount of hepatitis B virus in the blood. The tests also detect antibodies to the virus. Antibodies are proteins produced by your immune system to attack the virus.
People who have completely recovered from an acute hepatitis B infection usually have antibodies in their blood. But they do not have any detectable virus. People with acute or chronic hepatitis who have an active infection usually have detectable levels of virus in their blood.
Your doctor may suspect that you have significant liver damage. In this case, he or she may recommend a liver biopsy. In a biopsy, a small amount of tissue is removed and examined in a laboratory. It helps determine whether you are developing signs of cirrhosis.
Most people recover from an acute infection within three months. People may feel well during this time. But it may take up to four months before hepatitis B virus is no longer detected in the blood.
Chronic hepatitis B can be treated with a variety of medications. However, it rarely is cured.
You can prevent hepatitis B infection by avoiding exposure to the virus:
- Don't share needles for injecting intravenous drugs
- Don't have unprotected sex
In the United States, hepatitis B vaccine is offered to all children. Adults at high risk of exposure also should be immunized. These include medical personnel.
There is no cure for acute hepatitis B. Rather, treatment is aimed at reducing the amount of virus in the body, and easing the inflammation that causes the symptoms.
In rare cases, an episode of acute hepatitis B can be unusually severe. It may require hospitalization. A very small number of people with acute infection will develop liver failure. They require a liver transplant to prevent death.
Antiviral medications are one treatment option for people with chronic hepatitis B. They may be used for a person with significant inflammation or scarring of the liver whose blood contains virus. Not all people with chronic hepatitis B require treatment.
People with chronic liver disease that continues to worsen can be considered for a liver transplant. This procedure can be life saving. However, in most cases, the new liver eventually becomes infected with hepatitis B.
Call your doctor if you develop symptoms of hepatitis B. Severe symptoms may require hospital treatment.
If you have a chronic hepatitis B infection and you develop symptoms of advanced liver disease, seek immediate medical attention. Symptoms of advanced liver disease include:
- Swelling in your abdomen and legs
Severe acute hepatitis B can occur in a small number of cases and can sometimes be fatal.
In most cases of acute hepatitis B, people recover completely after the short-term infection. However, a small percentage of patients go on to develop chronic hepatitis B.
In people with chronic hepatitis B, the outlook depends upon the severity of liver inflammation. People with mild liver damage have a good prognosis. But some eventually develop cirrhosis or cancer. People with chronic active hepatitis and cirrhosis have a poorer prognosis.
American Liver Foundation
75 Maiden Lane
New York, NY 10038