Hepatitis B chronic living in adults

Overview

Chronic hepatitis B is a long-term infection of the liver caused by the hepatitis B virus (HBV). It means the virus stays in your body for more than six months and can slowly damage the liver over many years.

Yes, chronic hepatitis B is common worldwide especially in parts of Asia, Africa, and the Pacific Islands, but it can affect anyone. In the UK, it is less common but still found in certain groups.

It typically affects adults who were infected with hepatitis B earlier in life, often from birth or early childhood. Adults who get the virus later can also develop chronic infection, though this is less common.

Symptoms

Common symptoms

• Many people have no symptoms at all.
• Feeling very tired or lacking energy.
• Mild discomfort or ache in the upper right side of the belly (where the liver is).
• Yellowing of the eyes or skin (jaundice) may come and go.
• Dark urine or pale, clay-colored stools (less common).

Symptoms in children

• Children with chronic hepatitis B often have no symptoms. They may develop mild jaundice or tiredness, but many only know they have it through blood tests.

Symptoms in older adults

• Older adults may have more fatigue, joint aches, or swelling in the legs or belly due to fluid buildup. They are also at higher risk of liver damage.

Causes

Main causes

• Chronic hepatitis B is caused by the hepatitis B virus (HBV), which attacks the liver.
• You get the virus through contact with infected blood or body fluids, such as from an infected mother to baby during birth, through unprotected sex, or by sharing needles.

Risk factors

• Being born to a mother who has hepatitis B.
• Living in or traveling to areas where hepatitis B is common.
• Having unprotected sex with multiple partners or with someone who has hepatitis B.
• Sharing needles, syringes, or drug equipment.
• Working in healthcare and being exposed to blood.
• Getting a tattoo or piercing with unsterile equipment.
• Not being vaccinated against hepatitis B.

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number right away.
• If you notice new yellowing of your eyes or skin, or if your belly becomes swollen, seek immediate medical advice.

Book a routine appointment if:

• If you know you are at risk, get tested for hepatitis B even if you feel fine.
• If you have been diagnosed with chronic hepatitis B, stay in regular follow-up with your doctor as advised—usually every 6 to 12 months.

Diagnosis

Chronic hepatitis B is diagnosed with a simple blood test. Your doctor will order specific hepatitis B virus markers to see if the virus is present and active.

Tests that may be done

• Blood test for hepatitis B surface antigen (HBsAg) to confirm infection.
• Blood test for hepatitis B e antigen (HBeAg) and viral DNA (HBV DNA) to check how active the virus is.
• Liver function tests (LFTs) to see how well your liver is working.
• A liver ultrasound or FibroScan to check for scarring (cirrhosis).

What to expect at your appointment

Testing involves a simple blood draw at your doctor’s office or clinic. If the results show chronic infection, your doctor will talk with you about making a long-term care plan. You may also be referred to a liver specialist (hepatologist).

Treatment

Treatment for chronic hepatitis B aims to suppress the virus, reduce liver inflammation, and prevent liver damage. Not everyone needs treatment right away—your doctor will decide based on your test results and liver health.

Self-care at home

• Do not drink alcohol, as it can worsen liver damage.
• Avoid any medications or supplements that may harm the liver (ask your doctor first).
• Get vaccinated against hepatitis A to protect your liver from another infection.
• Practice good hygiene and avoid sharing personal items like toothbrushes or razors to prevent spreading the virus.

Medical treatments

Doctors may prescribe antiviral medicines taken by mouth to lower the amount of virus in your blood. These treatments are usually long-term. Some people may also receive injections of immune-boosting medicines. All treatments require regular monitoring by your healthcare team.

When is surgery considered?

Surgery is rarely needed for chronic hepatitis B itself. If the liver becomes severely damaged and starts to fail, a liver transplant may be considered. This is a major operation and only for advanced cases.

Living with this condition

Living with chronic hepatitis B means taking care of your liver and staying in touch with your doctor. You can work, travel, and enjoy life normally, but you need to avoid alcohol and check with your doctor before taking any new medicines or supplements.

Lifestyle tips

• Stay active with regular physical activity like walking, swimming, or yoga.
• Get plenty of rest and manage stress with healthy habits.
• Tell close family members about your condition so they can get tested and vaccinated if needed.
• Use condoms during sex to protect your partner from the virus.

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and lean protein. Limit foods high in salt, sugar, and unhealthy fats. Avoid raw or undercooked shellfish. Regular exercise helps your overall health and can improve liver function.

Mental health and emotional wellbeing

Living with a chronic illness can sometimes cause anxiety, sadness, or worry about the future. It is normal to feel this way. Talking to a counselor or joining a support group can help. If you ever feel overwhelmed, reach out to a trusted friend or mental health professional.

Prevention

Yes, hepatitis B can be prevented with a safe and effective vaccine. The vaccine is usually given as a series of shots.

Vaccines

The hepatitis B vaccine is recommended for all newborns, children, and adults at risk. If you already have chronic hepatitis B, the vaccine does not help you, but your family members and close contacts should get vaccinated.

Screening programmes

If you are at higher risk (see risk factors above), ask your doctor for a hepatitis B blood test. Early detection helps prevent complications.

Complications

If left untreated

• Liver damage that gets worse over time, leading to cirrhosis (scarring of the liver).
• Increased risk of liver cancer (hepatocellular carcinoma).
• Liver failure, where the liver stops working properly.

Long-term outlook

With proper monitoring and treatment, most people with chronic hepatitis B can live a long, healthy life and avoid serious liver problems. The key is to work closely with your healthcare team, take your medicines if prescribed, and make healthy lifestyle choices. Many people with the condition have normal lives and life expectancy.

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