- Hepatitis B is a viral infection that affects the liver and is spread primarily through contact with infected blood, semen, or other bodily fluids.
What is hepatitis B?
Hepatitis B is a viral infection that affects the liver. Hepatitis B begins as an "acute" infection, meaning it is often a short-term illness from which people recover.
In some cases, hepatitis B remains in the body and becomes a long-term or "chronic" infection. The younger a person is when he or she contracts hepatitis B, the more likely they are to develop a chronic infection.
How common is hepatitis B?
Between 800,000 and 1.4 million people in the United States are living with chronic hepatitis B. There are approximately 43,000 new hepatitis B cases each year in the United States.
How is hepatitis B spread?
Hepatitis B is more infectious than human immunodeficiency virus (HIV) and can be passed through the exchange of bodily fluids, such as semen, vaginal fluids, and blood. Hepatitis B is most commonly transmitted through:
- Sexual contact with an infected partner (this is the most common way adults and adolescents get the virus).
- Sharing needles and syringes.
- Sharing razors and toothbrushes (less common).
- Childbirth, if the mother has the infection.
Hepatitis B is not spread through sharing cups and utensils, or through hugging, kissing, shaking hands, or breastfeeding.
What are the symptoms of hepatitis B?
About 70 out of 100 adults with hepatitis B will develop symptoms. Some young children, especially those under age 5, are less likely to have symptoms but are at greater risk of developing chronic hepatitis B. On average, symptoms appear 90 days (or three months) after exposure, but they can appear any time between six weeks and six months after exposure.
What are the symptoms of acute hepatitis B?
If present, symptoms of acute hepatitis B might include:
- Jaundice (yellowing of the skin and eyes)
- Nausea and vomiting
- Abdominal pain
- Dark urine
- Joint pain
- Loss of appetite
- Malaise (feeling generally ill)
- Fatigue (feeling tired all the time)
What are the symptoms of chronic hepatitis B?
Some people have symptoms similar to acute hepatitis B, but most with chronic hepatitis B go as long as 20 to 30 years without any signs. Between 15 and 25 of every 100 people 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.
What are the risk factors for hepatitis B?
A risk factor is the chance that something will harm or otherwise affect a person's health.
Risk factors for hepatitis B include:
- Having sex with an infected person.
- Having multiple sex partners.
- Having a sexually transmitted disease.
- Being a man who has sex with other men.
- Injecting drugs or sharing needles, syringes, or other drug equipment.
- Receiving a body piercing or tattoo with non-sterile instruments.
- Living with a person who has chronic hepatitis B.
- Being born to an infected mother.
- Working in a health field and being exposed to blood.
- Receiving hemodialysis.
- Traveling to countries with moderate to high rates of hepatitis B.
Anyone can get hepatitis B. To protect against infection, a vaccine is available. The hepatitis B vaccine provides excellent protection against infection and is given in a series of three to four injections over six months. After receiving all doses, the hepatitis B vaccine provides greater than 90 percent protection to infants, children, and adults before being exposed to the virus. The vaccine is recommended for:
- Infants and children under age 19.
- Men who have sex with men.
- Sexual partners of those with hepatitis B.
- Injection drug users who share needles, syringes, or other equipment.
- Healthcare workers.
- Travelers to areas where hepatitis B is common.
- Patients with chronic liver disease.
For unvaccinated individuals with a recent exposure to someone with acute hepatitis B, an injection of hepatitis B immune globulin (HBIG) may prevent illness. An injection can provide protection for about three months.
There are several other things that can lower a person's risk of getting hepatitis B:
- Avoid sharing objects such as needles, razors, and toothbrushes.
- Always use condoms or another latex barrier (such as a dental dam) during sex (oral, anal, and vaginal). A barrier should be put on before any sexual contact takes place.
- Have sex with only one partner (who only has sex with you).
Are there tests for hepatitis B?
There are many tests available for hepatitis B, and they can be done as a single test or a series of several tests. Some tests for hepatitis B look for particles of the virus (antigens), while others look for substances the immune system produces in response to an infection (antibodies) to hepatitis B. Blood tests can also indicate if a person has acute or chronic hepatitis.
How is hepatitis B treated?
How is acute hepatitis B treated?
There is no medication to treat acute hepatitis B, which is typically an infection of short duration. Healthcare providers often recommend getting rest, drinking plenty of fluids, and eating a healthy diet.
How is chronic hepatitis B treated?
Anyone with chronic hepatitis B should be referred to a healthcare provider with specialized experience in treating hepatitis and liver diseases. There are several medications available to treat chronic hepatitis B, but not every case requires treatment. It is important that a patient with chronic hepatitis B is checked often to make sure their liver is healthy.
A person with hepatitis B should avoid alcohol and should consult with a healthcare provider before taking any supplements or over-the-counter medications (as some of these products can damage the liver).
I was treated for hepatitis B. When can I have sex again?
After treatment for hepatitis B, there is no waiting period needed to have sex. Because hepatitis B is most commonly spread through sexual contact, all heterosexual and homosexual persons, especially those with concurrent HIV infection, a new partner, or more than one partner, should protect their partners against transmission of hepatitis B by using a condom, even if you have been treated for hepatitis B.
I was treated for hepatitis B. Can I get it again?
No, a person who is treated for hepatitis B develops antibodies that provide protection from the virus for life. An antibody is a substance found in the blood that the body produces in response to a virus. Antibodies protect the body from disease by attaching to the virus and destroying it. However, some people, especially those infected during early childhood, may remain infected for life because they never clear the virus from their bodies.
What happens if I don't get treated?
For most people who are infected with acute hepatitis B, the virus will clear on its own without treatment and they will not develop the chronic infection. For others who develop chronic hepatitis B, lack of treatment could result in liver damage, liver cancer, or, in rare cases, death.
What are the implications of hepatitis B on pregnancy?
Pregnant women seeking prenatal care will receive a series of routine blood tests, including one that tests for the presence of hepatitis B. If a pregnant woman tests positive, she can pass hepatitis B to her baby during childbirth. This can be prevented by giving the infant hepatitis B immune globulin (HBIG) and the first dose of the hepatitis B vaccine within the 12 hours of birth. Two or three additional doses of the vaccine are needed over the next six months to help prevent hepatitis B. The timing and total number of shots will depend on the baby's age and birth weight.
Even if a pregnant woman does not have hepatitis B, the hepatitis B vaccine is recommended for all infants. The first dose is recommended before leaving the hospital.
Most babies who become infected with hepatitis B do not have symptoms but do have a 90 percent chance of developing chronic hepatitis B, which can eventually lead to serious health problems including liver damage, liver cancer, and even death.
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Content last reviewed on March 29, 2019