Hepatitis B (Chronic)
Chronic Hepatitis B
What is hepatitis B? — Hepatitis B is a serious disease that can harm the liver. The liver is a big organ in the upper right side of the belly (figure 1). A virus causes this disease. The virus spreads from person to person when their bodily fluids touch. This can happen in a few ways, like having sex or sharing needles.
What are the symptoms of hepatitis B? — When people first get hepatitis B (this is called "acute" hepatitis B), they can feel like they have the flu. People can also have:
Pain in the upper right side of the belly
Yellowing of the eyes or skin (called jaundice)
These symptoms usually get better, but it can take weeks to months.
Most people with hepatitis B get better within about 6 months. But 1 out of every 20 adults who gets hepatitis B ends up having the disease for a long time. This is called "chronic" hepatitis B.
Most people with chronic hepatitis B have no symptoms. But, over time, the infection can lead to a liver condition called cirrhosis. Symptoms of cirrhosis include:
Swelling in the belly and legs, and fluid build-up in the lungs
Bruising or bleeding easily
Confusion that can come on suddenly
Chronic hepatitis B also increases the risk of getting liver cancer.
How did I get the disease? — There are a few ways to catch the hepatitis B virus. All of them involve mixing bodily fluids with other people. You might have caught the disease by:
Having sex with someone who was infected
Sharing drug needles with someone who was infected
Using infected needles for tattooing, acupuncture, or piercings
Sharing toothbrushes, razors, or other personal items with someone who was infected
If your mother had hepatitis when she was pregnant with you, it's also possible you got the infection from her. This is especially likely if she is from a country where hepatitis B is common. In the same way, if you have hepatitis B and are pregnant, you can pass the infection on to your baby.
Is there a test for hepatitis B? — Yes. If your doctor or nurse suspects you have hepatitis B based on your symptoms, he or she will do blood tests to check for infection. Your doctor might also do these tests if you are at high risk of having hepatitis B, even if you don't have symptoms. For example, you might get tested if you live in an area where hepatitis B is common, or if you have had close contact with someone who might be infected.
Blood tests can also show if you have had hepatitis B in the past, even if the infection got better on its own.
Your doctor might also want to do tests to see if your liver is damaged. This can involve blood tests or tests to measure the liver's stiffness. Some people might get a liver biopsy. For this test, a doctor puts a needle into your liver and takes out a small sample of tissue. The sample will show how severe the damage is.
How is hepatitis B treated? — Most people with acute hepatitis B do not need treatment. The body usually gets rid of the infection on its own within about 6 months.
If you have chronic hepatitis, meaning the virus has not gone away after 6 months, your doctor might suggest taking medicine. However, not everyone with chronic hepatitis B needs treatment right away. If your doctor decides that you do not need to start treatment right away, he or she will monitor you over time. This involves doing regular blood tests. If the tests show that the virus is doing more damage to your liver, or if you start having new symptoms, you might start medicine at that time.
For people who do need treatment, it usually includes a medicine that fights the virus, called an "antiviral." People who take an antiviral usually need treatment for many years, and sometimes for life. In severe cases, a person might need a liver transplant, but this is rare. A liver transplant is surgery to replace a diseased liver with a healthy one.
In addition to getting treatment, your doctor or nurse might recommend getting an ultrasound test every 6 months. (An ultrasound creates pictures of the inside of the body.) This is to make sure you are not developing liver cancer.
Is there anything I can do to protect my liver? — Yes. You can:
Get vaccinated for hepatitis A and other diseases, including the flu and pneumonia
Ask your doctor or nurse before taking any over-the-counter pain medicines. (These medicines can sometimes damage the liver.)
How can I avoid giving the disease to other people? — If you have active hepatitis B infection, you can reduce your chances of spreading the virus by:
Making sure your family and close friends get tested and get the vaccine for hepatitis B
Using a latex condom every time you have sex
Not sharing razors, toothbrushes, or anything that might have blood on it
Not sharing needles or syringes
Using bandages to cover cuts and open sores
Cleaning drops of your blood off of things with a mixture of bleach and water. For the mixture, use 9 times more water than bleach.
What if I want to get pregnant? — If you have chronic hepatitis B and want to get pregnant, talk to your doctor or nurse first. If you are infected when you give birth, your baby should get special shots right away. These shots helps protect your baby from infection. You might also need treatment with a medicine for several weeks before giving birth. Plus, your baby will get a vaccine shot at 1 or 2 months old, and another one at 6 months. A test between 9 and 12 months will show if the baby has the disease. Your doctor will decide if he or she needs more vaccine shots at that time.
What will my life be like? — Many people with chronic hepatitis B are able to live normal lives. It is still safe to:
Hug and kiss
Share forks, spoons, and cups
Sneeze and cough around other people
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15382 Version 10.0
Release: 28.2.2 - C28.105
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