Hepatitis B – Symptoms and Causes

ByJanis Updated

Overview

Hepatitis B is a liver infection caused by HBV (hepatitis B virus). The infection comes in two forms: acute and chronic.

Acute hepatitis B resolves within six months, while chronic infections last longer and increase the risks of serious complications.

Chronic hepatitis B can lead to several serious conditions:

  • Liver failure
  • Liver cancer
  • Cirrhosis (severe liver scarring)

Most adults who contract hepatitis B recover completely, even with severe symptoms. However, infants and children face higher risks of developing chronic infections.

Prevention is possible through vaccination. Treatment approaches differ based on whether the infection is acute or chronic. Some patients require medication, while those with severe liver damage might need a liver transplant.

People with hepatitis B can take precautions to avoid spreading the virus to others. These safety measures are important for protecting public health and preventing further transmission of the disease.

Signs and Symptoms

Hepatitis B symptoms can vary from mild to severe. Symptoms usually begin 1 to 4 months after infection with the hepatitis B virus (HBV), though they might appear as early as two weeks after exposure.

Some people, especially young children, may not show any symptoms despite having acute or chronic hepatitis B.

Common symptoms of hepatitis B include:

  • Abdominal pain
  • Dark-colored urine
  • Fever
  • Joint pain
  • Reduced appetite
  • Nausea and vomiting
  • Weakness and extreme fatigue
  • Jaundice (yellowing of eye whites and skin) – may be more or less noticeable depending on skin tone

When to Contact a Healthcare Provider

Call your healthcare provider immediately if you know you’ve been exposed to the hepatitis B virus. Preventive treatment might reduce your infection risk if administered within 24 hours of exposure.

Don’t delay seeking medical attention if you experience symptoms that might indicate hepatitis B. Early diagnosis can help manage the condition effectively.

Causes

Hepatitis B infection occurs when the hepatitis B virus (HBV) enters the body through blood or other bodily fluids. Unlike some other viruses, HBV doesn’t spread through casual contact like sneezing or coughing.

The virus typically spreads through:

  • Sexual contact: Unprotected sex with an infected person can transmit the virus through blood, semen, vaginal fluids, or saliva.
  • Needle sharing: Using contaminated needles or syringes, especially during drug use.
  • Workplace exposure: Healthcare workers face risks from accidental needlesticks.
  • Mother-to-child transmission: An infected mother can pass the virus to her baby during childbirth, though vaccination can prevent infection in most newborns.

People at higher risk include those with multiple sexual partners, individuals who inject drugs, healthcare workers, and babies born to infected mothers.

Acute vs. Chronic HBV Infection

Hepatitis B infections fall into two main categories based on how long they last:

Acute Hepatitis B:

  • Lasts less than 6 months
  • The immune system successfully fights off the virus
  • Complete recovery usually occurs
  • Most adult infections start as acute cases
  • Can sometimes develop into chronic infection

Chronic Hepatitis B:

  • Persists for 6 months or longer
  • Occurs when the immune system fails to clear the virus
  • May continue throughout life
  • Can lead to serious liver complications including:
    • Liver scarring (cirrhosis)
    • Liver cancer
    • Liver failure

Age plays a crucial role in determining whether HBV becomes chronic. Children under 5 years old, and especially newborns, have a much higher risk of developing chronic infections compared to adults.

This happens because their immune systems aren’t fully developed enough to fight off the virus effectively.

Many people with chronic hepatitis B don’t experience symptoms for years or even decades. Some may feel ongoing fatigue or mild symptoms, while others remain completely symptom-free until liver damage becomes advanced.

Risk Factors

Hepatitis B virus (HBV) spreads through contact with blood, semen, or other body fluids from someone who has the infection. Several factors can increase your chance of getting HBV:

Sexual Activity

  • Having multiple sexual partners
  • Not using condoms during sex
  • Being a man who has sex with men

Contact with Blood

  • Sharing needles for drug injection
  • Working in jobs with blood exposure
  • Receiving dialysis treatments

Living Situations

  • Living with someone who has HBV
  • Current or former incarceration
  • Travel to high-risk areas, including parts of Asia, the Pacific Islands, Africa, and Eastern Europe

Health Conditions

  • Having hepatitis C or HIV
  • Taking medications that weaken your immune system (like chemotherapy)

Complications

Chronic hepatitis B infection can damage your body over time, leading to several serious health problems.

Liver Scarring (Cirrhosis)

When hepatitis B causes ongoing inflammation in the liver, scar tissue may gradually replace healthy liver tissue. This scarring, called cirrhosis, prevents the liver from functioning properly. People with cirrhosis may experience:

  • Fatigue and weakness
  • Easy bruising or bleeding
  • Swelling in the legs and abdomen
  • Jaundice (yellowing of skin and eyes)

Liver Cancer

Individuals with chronic hepatitis B face a significantly higher risk of developing liver cancer compared to those without the infection. Regular screening is important for early detection.

Liver Failure

In severe cases, hepatitis B can cause acute liver failure, where the liver rapidly loses its ability to function. This life-threatening condition typically requires a liver transplant as the only treatment option.

Viral Reactivation

Sometimes hepatitis B virus levels may be low or undetectable but then suddenly increase—called reactivation. This often happens in people with weakened immune systems, particularly those taking:

  • High-dose steroids
  • Chemotherapy drugs
  • Other immunosuppressive medications

If you need these treatments, doctors should test you for hepatitis B beforehand. Those who test positive should see a liver specialist before starting such medications.

Additional Complications

Beyond the liver, chronic hepatitis B can affect other body systems. Some patients develop kidney disease or inflammation of blood vessels, which can cause further health problems.

Ways to Prevent Hepatitis B

The hepatitis B vaccine offers the best protection against HBV infection. The vaccine is administered as either two shots given one month apart or three to four shots over six months, depending on the vaccine type.

It’s important to know that you cannot get hepatitis B from the vaccine itself.

In the United States, health experts recommend that babies receive their first vaccine dose shortly after birth. If you weren’t vaccinated as a child, vaccination is still recommended for everyone through age 59.

People aged 60 and older should get vaccinated if they have risk factors for exposure. Those over 60 without high risk can still choose to get the vaccine.

The vaccine is especially important for:

  • Newborns and children
  • People living or working in developmental disability centers
  • Household members of someone with hepatitis B
  • Healthcare and emergency workers
  • People with sexually transmitted infections
  • Men who have sex with men
  • People with multiple sexual partners
  • Sexual partners of hepatitis B patients
  • People who inject drugs
  • Those with chronic liver disease
  • People with end-stage kidney disease
  • Travelers to regions with high HBV rates

Beyond vaccination, you can take these steps to reduce your risk:

  1. Know your partner’s status – Understand the HBV status of any sexual partner before having unprotected sex.

  2. Use protection – Always use a new latex or polyurethane condom during sex if you’re unsure about your partner’s health status.

  3. Avoid illegal drugs: If you use drugs, seek help to stop. If you continue using, never share needles and always use sterile equipment.

  4. Be careful with body art: For tattoos and piercings:

    • Choose reputable shops
    • Ask about equipment cleaning procedures
    • Ensure sterile needles are used
    • Look elsewhere if you can’t get clear answers

  5. Plan ahead for travel: If visiting areas where hepatitis B is common, talk to your healthcare provider about vaccination before your trip.

Remember that the standard vaccine series requires multiple shots over several months.


Related Questions

Responses are AI-generated

Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.