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Hepatitis B

Hepatitis B is a high preventable liver disease caused by the hepatitis B virus (HBV). HBV causes the liver to swell and prevents it from working well.

About 95% of adults who are exposed to HBV fully recover within 6 months (acute HBV) without medication. About 5% have HBV all their lives (chronic HBV) unless they are successfully treated with medications. Infants born to mothers infected with HBV are at high risk of developing chronic HBV. Chronic HBV can lead to cirrhosis (scarring) of the liver, liver cancer, and liver failure.

  1. Between 850,000 and 2.2 million people in the United States are living with chronic Hepatitis B infection.
  2. About 70% of adults with Hepatitis B develop symptoms.
  3. Between 15%-25% of those with chronic Hepatitis B develop serious liver diseases such as cancer, cirrhosis (scarring of the liver), or liver failure, all of which can be fatal.

Read about how this Interactive Decision Support Tool draws upon expert consensus guidelines to provide customized recommendations on whether and how to treat hepatitis B in a specific patient setting. Depending on your location, you can choose whether to review advice from US, European, or Asia-Pacific guidelines.

The tool asks you a series of questions to define a specific HBV case and then presents personalized recommendations for exactly that individual.

Read More

Who is at risk of having hepatitis B?

Anyone who has come in direct contact with HBV-infected bodily fluids (blood, semen, and vaginal secretions) is at risk.

  • Were born to an HBV-infected mother
  • Work or live in a place where you can be exposed to infected blood, such as a healthcare institution or correctional facility
  • Have ever lived with a person infected with chronic HBV
  • Have ever had unprotected sex with an infected person
  • Have ever had multiple sexual partners
  • Have ever had a sexually transmitted disease
  • Are a man who has sex with men
  • Share needles or syringes to inject drugs, or straws to short them (even once)
  • Have your blood filtered by a machine (hemodialysis) because your kidneys aren’t working
  • Have ever traveled to  or are born in countries where HBV is common, including places in Africa, Central and Southeast Asia, and Eastern Europe

What are the symptoms of having hepatitis B?

A majority of adults develop symptoms from acute HBV infection; however, young children often do not. Symptoms, when they occur, may include:

  • Fever
  • Dark Urine
  • Joint Pain
  • Weakness and Fatigue
  • Loss of Appetite
  • Nausea and Vomiting
  • Abdominal pain near the liver

On average, symptoms appear three months after exposure to the virus, but they can appear anywhere between six weeks and six months. Symptoms usually last for a few weeks, but can last up to six months. Most adults infected with HBV recover fully even if their signs and symptoms are severe.

Some of the people who go on to develop chronic HBV have ongoing symptoms similar to acute HBV, but most people with chronic Hepatitis B remain symptom free for 20 or 30 years.

If you think you have signs of symptoms of Hepatitis B, contact your doctor.

How is hepatitis B diagnosed?

Hepatitis B is diagnosed by blood tests. There are several different blood tests available that can help your doctor determine whether you:

  • Could benefit from getting vaccinated
  • Have an acute or chronic infection
  • Have recovered from an infection
  • Are immune to HBV if you think you have signs of symptoms of HBV, contact your doctor.

Blood tests are done to check if HBV antibodies are in the body. Antibodies are proteins created by the immune system in response to viruses.

How is hepatitis B treated?

Acute HBV
Doctors often recommend bed rest, drinking lots of fluids, eating a healthy diet and avoiding alcohol. Medicines are not used to treat acute HBV. It is important to see your doctor regularly to make sure your body has fully recovered from the virus.

Chronic HBV
If you have chronic HBV, you should be monitored regularly for signs of liver disease and need for possible treatment. Not every person with chronic HBV needs medications and the drugs may cause side effects in some people. It is however important to have regular check-ups with your doctor to observe and watch your liver disease.

There are several medications approved to treat chronic HBV and many other medications are being developed. You should discuss these options with your doctor to find what is best for you.

HBV medications should not be taken by pregnant women unless recommended by their doctors. Some pregnant women with HBV should be treated to prevent transmitting HBV to their babies. It is important to closely follow up with your doctor during pregnancy to prevent to prevent transmission of Hepatitis B to their babies.

If you have chronic HBV, it’s important to talk to your doctor about treatment options and liver cancer screening every 6 months with an imaging test of the liver and cancer biomarkers in the blood. If you develop cirrhosis, you should ask your doctor about the complications of cirrhosis. Also, talk to your doctor about getting the Hepatitis A vaccine and being tested for Hepatitis C and Hepatitis D (Delta).

How can I prevent getting HBV?

The best way to prevent infection with HBV is by getting the HBV vaccine. It stimulate the body’s natural immune system to make antibodies – a substance found in the blood that protects you from disease- against HBV.

Other ways you can reduce your risk of getting HBV include:

  • Using sterile needles and equipment for tattoos or body piercings.
  • Using a new latex or polyurethane condom every time you have sex if you don’t know the health status of your partner
  • Asking your healthcare provider about getting vaccinated if you’re traveling to a region where HBV is common
  • Getting help to stop using drugs. If you can’t stop, use sterile needles and don’t share your needles or other drug paraphernalia.
  • Not sharing razors, toothbrushes, or other personal items with someone that has HBV.

Who should be vaccinated against hepatitis B?

Those who should be vaccinated against HBV include:

  • Newborns
  • Children and adolescents not vaccinated at birth
  • People with chronic liver disease not caused by HBV
  • Diabetics younger than 60 years of age
  • People who have had/or are on hemodialysis, those with end-stage renal disease including those on pre-dialysis care, peritoneal dialysis, and home dialysis
  • Healthcare and emergency workers, military personnel, morticians and others at risk for exposure to blood or blood-contained body fluids on the job
  • Residents and staff of facilities for developmentally disabled people
  • People working or house in prisons
  • People with a sexually transmitted disease
  • People with multiple sexual partners
  • Men who have sex with men
  • People with HIV
  • People who have ever injected or snorted drugs
  • Sexual partners and household members of people with HBV
  • Travels or those born in countries where HBV is common
  • People seeking protection from HBV, particularly members of ethnic or racial groups with high rate of HBV infection including Asian and Pacific Islander Americans, African Americans, Latino Americans, Native Americans, and Alaskan Natives
  • Immigrants from countries where HBV is common (Africa, Central and Southeast Asia, and Eastern Europe)
  • What kinds of therapy are possible to reduce my viral load?
  • Are there clinical trials looking at curing Hepatitis B?
  • Do I have liver damage?
  • Will I need a liver transplant?
  • Does my family need a booster vaccination?
  • What are the potential risks at infecting my partner with Hepatitis B?
  • How can I make my friends and family aware of what my condition is?
  • Should I be re-vaccinated for Hepatitis A?

Ask the Experts – Updates on Hepatitis A, Hepatitis B and Hepatitis C

Dr. Gina Choi of UCLA speaks about what has caused the most recent outbreaks of Hepatitis A in the United States. National Medical Advisory Committee Co-chair Dr. Sammy Saab discusses why Hepatitis B is so important to monitor. Nurse Practitioner Jacquelynne Prince discusses the opioid epidemic and why Hepatitis C ...

Ask the Experts Webinar: Updates in Management of Chronic Liver Disease

Date Recorded March 4, 2019 Program An American Liver Foundation webinar aired March 4th, 2019 featuring Dr. Eric W. Chak, MPH, Assistant Professor of Clinical Internal Medicine, UC Davis Medical Center, Dr. Alicia Gonzalez-Flores, Associate Physician, Internal Medicine, UC Davis Medical Center, Dr. Souvik Sarkar, PhD, Assistant Professor, Director of ...
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Hepatitis B
Healthy and Sick Livers

The Healthy Liver

A healthy liver has the amazing ability to grow back, or regenerate when damaged.


When treated successfully at this stage, there’s a chance your liver can heal itself.

Liver Cancer

Cirrhosis and hepatitis B are leading risk factors for primary liver cancer.

Liver Transplant

Removal of unhealthy liver and replace with a whole or portion of a healthy liver.

There are many different types of liver disease. But no matter what type you have, the damage to your liver is likely to progress in a similar way.

Whether your liver is infected with a virus, injured by chemicals, or under attack from your own immune system, the basic danger is the same – that your liver will become so damaged that it can no longer work to keep you alive.

Cirrhosis, liver cancer, and liver failure are serious conditions that can threaten your life. Once you have reached these stages of liver disease, your treatment options may be very limited.

That’s why it’s important to catch liver disease early, in the inflammation and fibrosis stages. If you are treated successfully at these stages, your liver may have a chance to heal itself and recover.

Talk to your doctor about liver disease. Find out if you are at risk or if you should undergo any tests or vaccinations.

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