Table of ContentsView AllTable of ContentsTypesTransmissionSymptomsDiagnosisTreatmentPrognosisPreventionCoping
Table of ContentsView All
View All
Table of Contents
Types
Transmission
Symptoms
Diagnosis
Treatment
Prognosis
Prevention
Coping
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Types of Hepatitis B
Of the adults who get the Hepatitis B virus, 95% clear the virus and do not go on to have the chronic form of the disease. Some people have few symptoms or none at all, so many do not realize they have HBV or that they have had it.
Many adults will clear the virus completely within six months.The good news is that the protective antibodies produced while fighting the infection mean that people who have had it will never have to worry about HBV again—they will be immune.
There are three types of hepatitis B infections:
Which Types of Hepatitis Have Higher Complications?
Hepatitis B is transmitted through contaminated bodily fluids like:
Transmission can also occur when using the same syringe as an infected person, like receivingblood transfusionsprior to 1975 (blood supplies are now screened in most countries) and getting tattoos or body piercings.
Hepatitis B can also be transmitted during childbirth from the pregnant person to the child, during medical procedures, through occupational exposure, and during sexual intercourse. Having Hepatitis B does not necessarily mean that a person isinfectious to other people—only some people with HBVare contagious.
Signs and Symptoms
There are many ways people may discover they have hepatitis. Because there are sometimes so few specific symptoms beyond fatigue, for example, that it may only be diagnosed when blood tests are performed—sometimes for unrelated reasons, such as prior to giving blood donations, for insurance purposes, for general health checks, or when following work-related injuries.
Acute Hepatitis B
In its severe form, hepatitis B symptoms can make the person feel extremely ill. Others may believe they have the flu while some may experience no symptoms at all.
Symptoms include jaundice, fever, abdominal pain, poor appetite, nausea, vomiting, fatigue, dark colored urine, light-colored stools, muscle andjoint pain, and rash.The liver may also be enlarged and tender.
Fulminant hepatitis is a severe but very rare form ofacute hepatitis. It may begin with fatigue and nausea, but, within a few weeks, the signs and symptoms become pronounced. About two weeks after jaundice develops, encephalopathy develops.
Encephalopathy is a state of impaired or altered mental status resulting from the inability of the damaged liver to remove toxins from the blood. In its mild form, there may be some short-term memory loss, forgetfulness, slurring of speech, small behavioral personality or behavioral changes, or changes in sleep patterns.
In its severe form, a person may experience severe loss of memory (not knowing the date, the year, their own name or address), confusion, exhibit inappropriate behavior, poor coordination, asterixis (uncontrollable flapping of the hands), fetor hepaticus (foul-smelling breath), and coma. Up to 85% of people with this type of rare hepatitis will die without aliver transplant.
Chronic Hepatitis B
Diagnostic Blood Tests
Blood tests will show the presence of the disease and what is affected. A hepatitis B serology blood test will give an accurate diagnosis of the type of hepatitis present as there are different strains of the virus.
The Centers for Disease Control and Prevention recommends hepatitis B screening for all adults, including those not at greater risk. The initial testing may include a “triple panel” that checks a sample of your blood for the presence of three different markers of hepatitis B infection.
Understanding the Hepatitis B e-Antigen (HBeAg)
Liver Function
High levels of transaminases in the blood do not always reveal how badly the liver is inflamed or damaged. Elevations in these can also occur as a result of genetic liver disease, liver tumors, and heart failure. The normal ranges of AST and ALT transaminases are around 0 to 40 IU/L and 0 to 45 IU/L respectively. In chronic hepatitis B, the levels are usually two to three times above the normal range.
Liver Proteins
Liver Biopsy
Response rates to the drugs in successful treatment programs are variable. In 2002, the FDA reported that it is “above 50% in patients with ALT levels greater than five times the upper normal limit of normal, but lower (20% to 35%) in patients with ALT levels less than two times the upper limit of normal. In patients with ALT levels less than two times the upper limit of normal, response rates are poor and therapy should be deferred.”
Acute hepatitis B is treated conservatively with rest and plenty of fluids. You may not need bed rest; it depends on how ill you feel.
If you are up to it, then there is no reason why you should not go to work. It is important to lead a healthy life, so stop smoking (try hard!) and eat a healthy diet. Definitely give up alcohol for a few months as the liver needs time to recover.
For those people whose bodies are unable to clear the virus, HBV will go on to become a chronic condition.Not long ago there was no treatment for hepatitis B; however, there are now a number of treatments available that are proving very effective.
The future is looking a lot brighter and scientists and drug companies are hoping that, within the next few years, a treatment will be discovered that will offer a cure for everyone with chronic hepatitis B.
Treatment with antiviral therapy is available for people with chronic hepatitis B although it is not recommended for all infected individuals. Treatment is aimed at the suppression of the hepatitis B virus and stopping the active liver disease.
Hepatitis B infection can lead to other health problems, including cirrhosis and liver cancer:
Prognosis is less favorable for those with the following factors:
Note: Hepatitis D (HDV) can only exist with the hepatitis B virus. Hepatitis D is transmitted in the same way as hepatitis B and can be caught at the same time as HBV (co-infection) or subsequent to HBV infection. Co-infection is known to clear the body well (90% to 95%). In the case of superinfection, 70% to 95% go on to have the more serious chronic form of HDV.
Avaccineis available and is advised for those who did not receive the vaccine at birth, as well as those at risk or in contact with the disease. The vaccine is 80% to 100% effective in preventing hepatitis B and the chronic form of the disease.
Seventy-nine percent of World Health Organization members have adopted the universal childhood hepatitis B vaccination policy.Unfortunately, the cost of the vaccination and the simple means of transmission of this virus mean that the overall incidence of hepatitis B infections continues to rise.
People who know they are infected carriers of the hepatitis B virus can take precautions to prevent infecting others. These include the appropriate disposal of contaminated waste, using separate toothbrushes and scissors, never sharing needles and syringes with others, alwaysusing condoms, and avoidinganal intercourse.
If your job involves working in high-risk areas, you should consult your healthcare provider for advice on precautions and any effects that it may have on your future health. All people infected with hepatitis B should get a hepatitis A vaccine to prevent potential infection.
Hepatitis B Vaccine Schedule for Adults
If you find out you have hepatitis B, don’t despair. Get a healthcare provider specializing in hepatology to advise you on the best treatments and on how you can maximize your health to fight the virus.
Remember, you are not alone. There are millions of people with hepatitis B. Find a local support group through the internet or ask your medical team that is providing your care what support systems are available to you.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Rajbhandari R, Chung RT.Treatment of hepatitis B: A concise review.Clin Transl Gastroenterol. 2016;7(9):190. doi:10.1038/ctg.2016.46American Chemical Society.Toward explaining why hepatitis B hits men harder than women.Seto WK, Lo YR, Pawlotsky JM, Yuen MF.Chronic hepatitis B virus infection.The Lancet. 2018;392(10161):2313-2324. doi:10.1016/S0140-6736/2818World Health Organization.Hepatitis B.Ferenci P.Hepatic encephalopathy.Gastroenterol Rep (Oxf). 2017;5(2):138-147. doi:10.1093/gastro/gox013Conners EE, Panagiotakopoulos L, Hofmeister MG, et al.Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations - United States, 2023.MMWR Recomm Rep. 2023;72(1):1-25. Published 2023 Mar 10. doi:10.15585/mmwr.rr7201a1Gerlich WH.Medical Virology of Hepatitis B: how it began and where we are now.Virol J. 2013;10(1):239. doi:10.1186/1743-422X-10-239Terrault NA, Lok ASF, McMahon BJ, et al.Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance.Hepatology. 2018;67(4):1560-1599. doi:10.1002/hep.29800Food and Drug Administration.Product information: interferon alfa- 2b.Food and Drug Administration.Hepsera (adefovir dipivoxil) tablets.Guan R, Lui HF.Treatment of hepatitis b in decompensated liver cirrhosis.International Journal of Hepatology. 2011;2011:1-11. doi:10.4061/2011/918017Fattovich G, Bortolotti F, Donato F.Natural history of chronic hepatitis B: Special emphasis on disease progression and prognostic factors.Journal of Hepatology. 2008;48(2):335-352. doi:10.1016/j.jhep.2007.11.011Centers for Disease Control and Prevention.Hepatitis D Questions and Answers for Health Professionals.Centers for Disease Control and Prevention.Hepatitis B.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Rajbhandari R, Chung RT.Treatment of hepatitis B: A concise review.Clin Transl Gastroenterol. 2016;7(9):190. doi:10.1038/ctg.2016.46American Chemical Society.Toward explaining why hepatitis B hits men harder than women.Seto WK, Lo YR, Pawlotsky JM, Yuen MF.Chronic hepatitis B virus infection.The Lancet. 2018;392(10161):2313-2324. doi:10.1016/S0140-6736/2818World Health Organization.Hepatitis B.Ferenci P.Hepatic encephalopathy.Gastroenterol Rep (Oxf). 2017;5(2):138-147. doi:10.1093/gastro/gox013Conners EE, Panagiotakopoulos L, Hofmeister MG, et al.Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations - United States, 2023.MMWR Recomm Rep. 2023;72(1):1-25. Published 2023 Mar 10. doi:10.15585/mmwr.rr7201a1Gerlich WH.Medical Virology of Hepatitis B: how it began and where we are now.Virol J. 2013;10(1):239. doi:10.1186/1743-422X-10-239Terrault NA, Lok ASF, McMahon BJ, et al.Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance.Hepatology. 2018;67(4):1560-1599. doi:10.1002/hep.29800Food and Drug Administration.Product information: interferon alfa- 2b.Food and Drug Administration.Hepsera (adefovir dipivoxil) tablets.Guan R, Lui HF.Treatment of hepatitis b in decompensated liver cirrhosis.International Journal of Hepatology. 2011;2011:1-11. doi:10.4061/2011/918017Fattovich G, Bortolotti F, Donato F.Natural history of chronic hepatitis B: Special emphasis on disease progression and prognostic factors.Journal of Hepatology. 2008;48(2):335-352. doi:10.1016/j.jhep.2007.11.011Centers for Disease Control and Prevention.Hepatitis D Questions and Answers for Health Professionals.Centers for Disease Control and Prevention.Hepatitis B.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Rajbhandari R, Chung RT.Treatment of hepatitis B: A concise review.Clin Transl Gastroenterol. 2016;7(9):190. doi:10.1038/ctg.2016.46American Chemical Society.Toward explaining why hepatitis B hits men harder than women.Seto WK, Lo YR, Pawlotsky JM, Yuen MF.Chronic hepatitis B virus infection.The Lancet. 2018;392(10161):2313-2324. doi:10.1016/S0140-6736/2818World Health Organization.Hepatitis B.Ferenci P.Hepatic encephalopathy.Gastroenterol Rep (Oxf). 2017;5(2):138-147. doi:10.1093/gastro/gox013Conners EE, Panagiotakopoulos L, Hofmeister MG, et al.Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations - United States, 2023.MMWR Recomm Rep. 2023;72(1):1-25. Published 2023 Mar 10. doi:10.15585/mmwr.rr7201a1Gerlich WH.Medical Virology of Hepatitis B: how it began and where we are now.Virol J. 2013;10(1):239. doi:10.1186/1743-422X-10-239Terrault NA, Lok ASF, McMahon BJ, et al.Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance.Hepatology. 2018;67(4):1560-1599. doi:10.1002/hep.29800Food and Drug Administration.Product information: interferon alfa- 2b.Food and Drug Administration.Hepsera (adefovir dipivoxil) tablets.Guan R, Lui HF.Treatment of hepatitis b in decompensated liver cirrhosis.International Journal of Hepatology. 2011;2011:1-11. doi:10.4061/2011/918017Fattovich G, Bortolotti F, Donato F.Natural history of chronic hepatitis B: Special emphasis on disease progression and prognostic factors.Journal of Hepatology. 2008;48(2):335-352. doi:10.1016/j.jhep.2007.11.011Centers for Disease Control and Prevention.Hepatitis D Questions and Answers for Health Professionals.Centers for Disease Control and Prevention.Hepatitis B.
Rajbhandari R, Chung RT.Treatment of hepatitis B: A concise review.Clin Transl Gastroenterol. 2016;7(9):190. doi:10.1038/ctg.2016.46
American Chemical Society.Toward explaining why hepatitis B hits men harder than women.
Seto WK, Lo YR, Pawlotsky JM, Yuen MF.Chronic hepatitis B virus infection.The Lancet. 2018;392(10161):2313-2324. doi:10.1016/S0140-6736/2818
World Health Organization.Hepatitis B.
Ferenci P.Hepatic encephalopathy.Gastroenterol Rep (Oxf). 2017;5(2):138-147. doi:10.1093/gastro/gox013
Conners EE, Panagiotakopoulos L, Hofmeister MG, et al.Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations - United States, 2023.MMWR Recomm Rep. 2023;72(1):1-25. Published 2023 Mar 10. doi:10.15585/mmwr.rr7201a1
Gerlich WH.Medical Virology of Hepatitis B: how it began and where we are now.Virol J. 2013;10(1):239. doi:10.1186/1743-422X-10-239
Terrault NA, Lok ASF, McMahon BJ, et al.Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance.Hepatology. 2018;67(4):1560-1599. doi:10.1002/hep.29800
Food and Drug Administration.Product information: interferon alfa- 2b.
Food and Drug Administration.Hepsera (adefovir dipivoxil) tablets.
Guan R, Lui HF.Treatment of hepatitis b in decompensated liver cirrhosis.International Journal of Hepatology. 2011;2011:1-11. doi:10.4061/2011/918017
Fattovich G, Bortolotti F, Donato F.Natural history of chronic hepatitis B: Special emphasis on disease progression and prognostic factors.Journal of Hepatology. 2008;48(2):335-352. doi:10.1016/j.jhep.2007.11.011
Centers for Disease Control and Prevention.Hepatitis D Questions and Answers for Health Professionals.
Centers for Disease Control and Prevention.Hepatitis B.
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