Hepatitis B
Sources consulted
This article is original patient-education content.
- WHO—Hepatitis B fact sheet(2023)
- NHS—Hepatitis B(2023)
- CDC—Hepatitis B(2024)
- EASL—EASL Clinical Practice Guidelines on Hepatitis B(2017)
Based on international clinical guidelines
Overview
Hepatitis B is a viral infection that causes inflammation of the liver. The liver is a vital organ that helps digest food, store energy, and remove toxins. Most people with hepatitis B recover fully, but some develop a long-term (chronic) infection that can lead to serious liver damage.
Key facts
- Hepatitis B is spread through contact with infected blood or body fluids, such as from sharing needles or unprotected sex.
- Many people with hepatitis B have no symptoms, especially when first infected.
- A safe and effective vaccine can prevent hepatitis B infection.
Hepatitis B is common worldwide. In the UK, it is less common than in some parts of Asia and Africa, but cases still occur, especially among people born in countries where hepatitis B is widespread.
Anyone can get hepatitis B, but it is more common in people who have contact with infected blood or body fluids, such as healthcare workers, people who inject drugs, and babies born to infected mothers.
Symptoms
- Signs of severe liver damage: confusion, unusual sleepiness, or difficulty waking up
- Vomiting blood or passing black, tarry stools
- Severe abdominal pain that does not go away
- ⚠Yellow skin or eyes (jaundice) that appears suddenly
- ⚠Dark urine and pale stools
- ⚠Severe tiredness that interferes with daily activities
Common symptoms
- Feeling very tired
- Loss of appetite
- Nausea or vomiting
- Pain in the upper right side of the belly (abdomen)
- Jaundice (yellowing of the skin and whites of the eyes)
- Dark urine and pale-colored stools
Symptoms in children
- Most children under 5 with hepatitis B have no symptoms at all.
- If symptoms do occur, they are usually mild, such as tiredness or poor feeding.
Symptoms in older adults
- Older adults are more likely to have symptoms, which can be more severe.
- They may also be at higher risk of developing chronic hepatitis B.
Causes
Main causes
- Hepatitis B is caused by the hepatitis B virus (HBV). It is spread when infected blood, semen, or other body fluids enter a person’s body.
- Common ways include: sharing needles or syringes, unprotected sex with an infected person, from an infected mother to her baby during birth, or by accidental needle sticks in healthcare settings.
Risk factors
- Living in or traveling to areas where hepatitis B is common (e.g., parts of Asia, Africa, the Pacific Islands)
- Having unprotected sex with multiple partners or with someone who has hepatitis B
- Injecting drugs or sharing drug equipment
- Being a healthcare worker who may be exposed to blood
- Being born to a mother infected with hepatitis B
- Having a weakened immune system (e.g., from HIV or certain medications)
When to see a doctor
See a doctor urgently if:
- If you have symptoms of severe liver damage (see emergency signs above), call your local emergency number immediately.
- If you develop jaundice (yellow skin or eyes), dark urine, or pale stools, see a doctor the same day.
Book a routine appointment if:
- If you think you may have been exposed to hepatitis B – for example, through a needle stick or unprotected sex – talk to your doctor as soon as possible. You may need a vaccine or medication to prevent infection.
- If you have ongoing fatigue, nausea, or abdominal discomfort that does not go away, make a routine appointment.
Diagnosis
Hepatitis B is diagnosed with a simple blood test. The test checks for signs of the virus or antibodies that your body makes to fight it.
Tests that may be done
- Blood test for hepatitis B surface antigen (HBsAg) – to see if you currently have the virus
- Blood test for hepatitis B core antibody (anti-HBc) – to see if you have ever been infected
- Blood test for hepatitis B surface antibody (anti-HBs) – to see if you are immune (from past infection or vaccine)
What to expect at your appointment
The blood test is quick and is done at your doctor's office or a clinic. You may need to wait a few days for results. If you have chronic hepatitis B, your doctor may also recommend imaging tests (like an ultrasound) to check your liver.
Treatment
Treatment for hepatitis B depends on whether the infection is acute (short-term) or chronic (long-term). Most acute infections do not need medicine and clear up on their own with rest and good nutrition. Chronic hepatitis B is managed with antiviral medications that help control the virus and prevent liver damage. Your doctor will decide the best treatment plan for you.
Self-care at home
- Get plenty of rest – your body needs energy to fight the virus.
- Drink lots of fluids, especially water, to stay hydrated.
- Eat a balanced diet with fruits, vegetables, and whole grains.
- Avoid alcohol completely – it can harm your liver.
- Do not take any new medicines, including over-the-counter or herbal remedies, without checking with your doctor.
Medical treatments
For chronic hepatitis B, antiviral medications are used to reduce the amount of virus in your body and lower the risk of liver damage. Treatment is usually long-term and may involve one or more medicines. Your doctor will monitor you regularly with blood tests and liver scans to see how well the treatment is working and adjust it if needed. In some cases, a liver transplant may be considered if the liver is severely damaged.
When is surgery considered?
Surgery is not a common treatment for hepatitis B itself. If the infection leads to severe liver damage or liver cancer, a liver transplant may be an option. This is only considered after other treatments have been tried and your doctor has done a thorough evaluation.
Living with this condition
Living with hepatitis B, especially the chronic form, means taking care of your liver and overall health. You will need regular check-ups with your doctor. Most people with chronic hepatitis B can live full, active lives by following their treatment plan and making healthy choices.
Lifestyle tips
- Avoid alcohol – even small amounts can damage your liver.
- Do not share needles, razors, toothbrushes, or anything that might have blood on it.
- Use condoms during sex to protect your partner from the virus.
- Tell your healthcare providers that you have hepatitis B so they can protect themselves and you.
- Get vaccinated against hepatitis A if you are not already immune – it is safe and recommended.
Diet and exercise
Eat a healthy, balanced diet that is low in fat and includes plenty of fruits, vegetables, lean proteins, and whole grains. Avoid fatty or fried foods. Gentle exercise like walking or swimming can help keep you fit and improve your mood. Talk to your doctor before starting any new exercise routine.
Mental health and emotional wellbeing
Being diagnosed with a chronic infection can be stressful. It is normal to feel anxious, sad, or worried about your health and the future. If you are struggling, talk to your doctor or a mental health professional. You are not alone.
Prevention
Yes, hepatitis B can be prevented with a safe and effective vaccine. It is recommended for all babies, children, and adults at risk. Other prevention measures include practicing safe sex, not sharing needles, and wearing gloves if you might come into contact with blood.
Vaccines
The hepatitis B vaccine is given as a series of injections, usually over 6 months. It is very effective at preventing infection. In the UK, it is offered to all babies as part of the routine childhood vaccination schedule, and to adults at higher risk.
Screening programmes
Screening for hepatitis B is not routine for everyone, but it is recommended for pregnant women, people born in countries with a high rate of hepatitis B, and people with certain risk factors. Talk to your doctor about whether you should be tested.
Complications
If left untreated
- Chronic hepatitis B can lead to serious liver damage, including cirrhosis (scarring of the liver) and liver cancer.
- People with chronic hepatitis B have a higher risk of developing liver failure.
- A small number of people with acute hepatitis B may develop a severe form called fulminant hepatitis, which can be life-threatening.
Long-term outlook
The outlook for hepatitis B is generally good, especially with early detection and proper care. Most adults with acute hepatitis B recover completely. For chronic hepatitis B, treatments can control the virus and prevent complications, allowing many people to live long, healthy lives. Regular monitoring and a healthy lifestyle are key.
Find support
International organisations
Local organisations
- Hepatitis B UK ↗ · UK
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.