Hepatitis B infection is caused by the hepatitis B virus (HBV).You can catch hepatitis B through contact with the blood or body fluids (such as semen, vaginal fluids, and saliva) of a person who has the virus.
Exposure may occur:
After a needle stick or sharps injury
If any blood or other body fluid touches your skin, eyes or mouth
People who may be at risk of hepatitis B are those who:
Have unprotected sex with an infected partner
Receive blood transfusions (not common in the United States)
Have contact with blood at work (such as health care workers)
Have been on long-term kidney dialysis
Get a tattoo or acupuncture with unclean needles
Share needles during drug use
Share personal items (such as toothbrush, razor, and nail clippers) with a person who has the virus
Were born to a hepatitis-B infected mother
Symptoms
After you first become infected with the hepatitis B virus:
You may have no symptoms
You may feel sick for a period of days or weeks
You may become very ill very quickly (called fulminant hepatitis)
Symptoms of hepatitis B may not appear for up to 6 months after the time of infection. Early symptoms include:
Appetite loss
Fatigue
Low fever
Muscle and joint aches
Nausea and vomiting
Yellow skin and dark urine
Symptoms will go away in a few weeks to months if your body is able to fight off the infection. Some people never get rid of the hepatitis B virus. This is called chronic hepatitis B.
People with chronic hepatitis may not have symptoms and not know they are infected. Over time, they may develop symptoms of liver damage and cirrhosis of the liver.
You can spread the hepatitis B virus to other people even if you have no symptoms.
Signs and tests
A series of blood tests called the hepatitis viral panel is done to help diagnose the condition.
The following tests are done to look for liver damage if you have chronic hepatitis B:
You will also have a test to measure the level of HPV in your blood (viral load). This lets your doctors know how your treatment is working.
Treatment
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.
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. It is not always clear which patients with chronic hepatitis B should receive drug therapy and when drug therapy should be started. You are more likely to receive these medicines if:
Your liver function is becoming worse quickly
You develop symptoms of long-term liver damage
You have high levels of the hepatitis B virus in your blood
If you develop rapid liver failure, you may need a liver transplant. A liver transplant is the only cure in some cases of liver failure.
Other recommendations:
Avoid alcohol.
Check with your doctor or nurse before taking any over-the-counter medications or herbal supplements. This includes medications such as acetaminophen, aspirin, or ibuprofen.
Severe liver damage, or cirrhosis, can be 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 most people.
Almost all newborns and about half of children who get hepatitis B develop the chronic condition. Very few adults who get the virus develop chronic hepatitis B.
About 1 in 100 people who get hepatitis B dies from the condition.
There is a much higher rate of liver cancer in people who have chronic hepatitis B.
Calling your health care provider
Call your health care provider if:
You develop symptoms of hepatitis B
Hepatitis B symptoms do not go away in 2 - 3 weeks, or new symptoms develop
You belong to a high-risk group for hepatitis B and have not had the HBV vaccine.
Prevention
Children and people at high risk for hepatitis B should get the hepatitis B vaccine.
Babies should get a first dose of the hepatitis B vaccine at birth. They should have all three shots in the series by age 6 months.
Children younger than age 19 who have not had the vaccine should get "catch-up" doses.
Health care workers and those who live with someone who has hepatitis B should get the vaccine.
Infants born to mothers who have acute hepatitis B or have had the infection in the past should get a special hepatitis B vaccine within 12 hours of birth.
All blood used for blood transfusions is screened, so the chance of getting the virus in this way is very small.
The hepatitis B vaccine or a hepatitis immune globulin (HBIG) shot may help prevent infection if you receive it within 24 hours of contact with the virus.
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.
Review Date:
11/25/2012
Reviewed By:
George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
