Hepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV).
Other types of viral hepatitis include:
Hepatitis B infection can be spread through having contact with the blood, semen, vaginal fluids, and other body fluids of someone who already has a hepatitis B infection.
Infection can be spread through:
The hepatitis B virus can be passed to an infant during childbirth if the mother is infected.
Risk factors for hepatitis B infection include:
Most of the damage from the hepatitis B virus occurs because of the way the body responds to the infection. When the body's immune system detects the infection, it sends out special cells to fight it off. However, these disease-fighting cells can lead to liver inflammation.
After you first become infected with the hepatitis B virus:
If your body is able to fight off the hepatitis B infection, any symptoms that you had should go away over a period of weeks to months.
Some people's bodies are not able to completely get rid of the hepatitis B infection. This is called chronic hepatitis B.
Many people who have chronic hepatitis B have few or no symptoms. They may not even look sick. As a result, they may not know they are infected. However, they can still spread the virus to other people.
Symptoms may not appear for up to 6 months after the time of infection. Early symptoms may include:
People with chronic hepatitis may have no symptoms, even though gradual liver damage may be occurring. Over time, some people may develop symptoms of chronic liver damage and cirrhosis of the liver.
The following tests are done to identify and monitor liver damage from hepatitis B:
The following tests are done to help diagnose and monitor people with hepatitis B:
Patients with chronic hepatitis will need ongoing blood tests to monitor their status.
Acute hepatitis needs no treatment other than careful monitoring of liver and other body functions with blood tests. You should get plenty of bed rest, drink plenty of fluids, and eat healthy foods.
In the rare case that you develop liver failure, you may need a liver transplant. A liver transplant is the only cure in some cases of liver failure.
Some patients with chronic hepatitis may be treated with antiviral medications or a medication called peginterferon. These medications can decrease or remove hepatitis B from the blood and reduce the risk of cirrhosis and liver cancer.
Liver transplantation is used to treat severe, chronic hepatitis B liver disease.
Patients with chronic hepatitis should avoid alcohol and should always check with their doctor or nurse before taking any over-the-counter medications or herbal supplements. This even includes medications such as acetaminophen, aspirin, or ibuprofen.
See: Cirrhosis for information about treating more severe liver damage caused by hepatitis B.
The acute illness usually goes away after 2 - 3 weeks. The liver usually returns to normal within 4 - 6 months in almost all patients who are infected.
Some people develop chronic hepatitis.
Hepatitis B is fatal in about 1% of cases.
There is a much higher rate of hepatocellular carcinoma in people who have chronic hepatitis B than in the general population.
Other complications may include:
Call your health care provider if:
All children should receive their first dose of the hepatitis B vaccine at birth, and complete the series of three shots by age 6 months. Children younger than age 19 who have not been vaccinated should receive "catch-up" doses.
People who are at high risk, including health care workers and those who live with someone who has hepatitis B should get the hepatitis B vaccine.
Infants born to mothers who either currently have acute hepatitis B, or who have had the infection should receive a special vaccination that includes hepatitis B immune globulin and a hepatitis B immunization within 12 hours of birth.
Screening of all donated blood has reduced the chance of getting hepatitis B from a blood transfusion. Mandatory reporting of the disease allows state health care workers to track people who have been exposed to the virus. The vaccine is given to those who have not yet developed the disease.
The hepatitis B vaccine or a hepatitis B immune globulin (HBIG) shot may help prevent hepatitis B infection if it is given within 24 hours of exposure.
Lifestyle measures for preventing transmission of hepatitis B:
Hepatitis B (and hepatitis C) viruses cannot be spread by casual contact, such as holding hands, sharing eating utensils or drinking glasses, breast-feeding, kissing, hugging, coughing, or sneezing.
Dienstag JL. Hepatitis B virus infection. N Engl J Med. 2008;359:1486-1500.
Perrillo R. Hepatitis B and D. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 78.
Sorrell MF, Belongia EA, Costa J, Gareen IF, Grem JL, Inadomi JM, et al. National Institutes of Health Consensus Development Conference Statement: Management of hepatitis B. Ann Intern Med. 2009;150:104-10.
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