Introduction

Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). For some people, hepatitis B infection becomes chronic, meaning it lasts more than six months. Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis — a condition that causes permanent scarring of the liver.

Most people infected with hepatitis B as adults recover fully, even if their signs and symptoms are severe. Infants and children are more likely to develop a chronic hepatitis B infection. A vaccine can prevent hepatitis B, but there's no cure if you have it. If you're infected, taking certain precautions can help prevent spreading HBV to others.

Hepatitis B infection is caused by the hepatitis B virus (HBV). The virus is passed from person to person through blood, semen or other body fluids.

Common ways HBV is transmitted include:

• Mother to child. Pregnant women infected with HBV can pass the virus to their babies during childbirth. However, the newborn can be vaccinated to avoid getting infected in almost all cases. Talk to your doctor about being tested for hepatitis B if you are pregnant or want to become pregnant.
• Sharing of needles. HBV is easily transmitted through needles and syringes contaminated with infected blood. Sharing intravenous (IV) drug paraphernalia puts you at high risk of hepatitis B.
• Accidental needle sticks. Hepatitis B is a concern for health care workers and anyone else who comes in contact with human blood.
• Sexual contact. You may become infected if you have unprotected sex with an infected partner whose blood, saliva, semen or vaginal secretions enter your body.

  Acute vs. chronic hepatitis B

  Hepatitis B infection may be either short-lived (acute) or long lasting (chronic).

• Acute hepatitis B infection lasts less than six months. Your immune system likely can clear acute hepatitis B from your body, and you should recover completely within a few months. Most people who acquire hepatitis B as adults have an acute infection, but it can lead to chronic infection.
• Chronic hepatitis B infection lasts six months or longer. When your immune system can't fight off the acute infection, hepatitis B infection may last a lifetime, possibly leading to serious illnesses such as cirrhosis and liver cancer.

  The younger you are when you get hepatitis B — particularly newborns or children younger than 5 — the higher your risk the infection becoming chronic. Chronic infection may go undetected for decades until a person becomes seriously ill from liver disease.

   

  Having a chronic HBV infection can lead to serious complications, such as:

• Scarring of the liver (cirrhosis). The inflammation associated with a hepatitis B infection can lead to extensive liver scarring (cirrhosis), which may impair the liver's ability to function.
• Liver cancer. People with chronic hepatitis B infection have an increased risk of liver cancer.
• Liver failure. Acute liver failure is a condition in which the vital functions of the liver shut down. When that occurs, a liver transplant is necessary to sustain life.

   

  Diagnosis

  If your doctor suspects you have hepatitis B, he or she will examine you and likely order blood tests. Blood tests of hepatitis B specific antigen and antibody can determine if you have the virus in your system and whether it's acute or chronic.

  Screening healthy people for hepatitis B

  Doctors sometimes test certain healthy people for hepatitis B infection because the virus can damage the liver before causing signs and symptoms. Talk to your doctor about screening for hepatitis B infection if you:

• Have a liver enzyme test with unexplained abnormal results
• Have HIV or hepatitis C
• Inject illegal drugs
• Receive kidney dialysis
• Take medications that suppress the immune system, such as anti-rejection medications used after an organ transplant
• Are pregnant
• Live with someone who has hepatitis B
• Have had sex with someone who has hepatitis B

  Treatment for acute hepatitis B infection

  If your doctor determines your hepatitis B infection is acute — meaning it is short-lived and will go away on its own — you may not need treatment. Instead, your doctor might recommend rest and adequate nutrition and fluids while your body fights the infection.

  Treatment for chronic hepatitis B infection

  If you've been diagnosed with chronic hepatitis B infection, you may have treatment to reduce the risk of liver disease and prevent you from passing the infection to others. Treatments include:

• Antiviral medications. Several antiviral medications — including lamivudine, adefovir, telbivudine, entecavir and tenofovir — can help fight the virus and slow its ability to damage your liver. Talk to your doctor about which medication might be right for you.
• Interferon alfa-2b (Intron A). This synthetic version of a substance produced by the body to fight infection is used mainly for young people with hepatitis B who don't want to undergo long-term treatment or who might want to get pregnant within a few years. It's given by injection. Side effects may include depression, difficulty breathing and chest tightness.
• Liver transplant. If your liver has been severely damaged, a liver transplant may be an option. During a liver transplant, the surgeon removes your damaged liver and replaces it with a healthy liver. Most transplanted livers come from deceased donors, though a small number come from living donors who donate a portion of their livers.

   

  Vaccination

  The hepatitis B vaccine is recommended for:

• Newborns
• Children and adolescents not vaccinated at birth
• Anyone who has a sexually transmitted infection, including HIV
• Developmentally disabled people who live in an institutional setting and staff
• Health care workers, emergency workers and other people who come into contact with blood
• People who live with someone who has hepatitis B
• Sexual partners of someone who has hepatitis B

Travelers planning to go to an area of the world with a high hepatitis B infection rate