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Hepatitis B Causes, Symptoms, and Treatments

Hepatitis B is a virus that infects the liver and can lead to long-term infection. It can cause serious health problems, including cancer, liver failure, and death.

At UPMC, our liver disease experts provide quick diagnoses, close surveillance, and tailored treatment plans for people with hepatitis B. This prevents long-term health problems and helps you live a long, full life.

We also screen people at risk of hep B and provide vaccines to prevent the spread of the hepatitis B virus.

To make an appointment at the UPMC Center for Liver Diseases, call 412-647-1170 or fill out our contact form.


What Is Hepatitis B?

Hepatitis B is a type of liver disease caused by the hepatitis B virus (HBV). There are two types of hepatitis B infection.

Acute hep B infection occurs within six months of exposure to HBV. Some people may not have any symptoms at this point and may not know they have an infection. Others may have severe symptoms, such as vomiting that requires a hospital stay.

Chronic hep B lasts beyond six months of exposure to the virus. It occurs in around 5% to 10% of adults exposed to the virus.

Most infants and young children who get an acute infection end up with a chronic illness. This is because their immune systems aren't mature enough to fight off the virus.

Many people with chronic hep B have it for life. But medicine can slow and even stop the virus from causing further damage.

Hepatitis B causes

You can catch this virus through contact with body fluids of an infected person, such as:

  • Blood.
  • Semen.
  • Vaginal fluids.
  • Saliva.

Spread can occur through close contact, including:

  • Sexual contact.
  • Sharing needles.
  • Accidental needle sticks.
  • Mother to child.

A woman with hep B can pass the virus to her baby during childbirth. If you're pregnant and have hepatitis B, it's crucial to talk to your ob-gyn about treatments to protect your baby.

You can't catch hep B from:

  • Sneezing or coughing.
  • Kissing or hugging.
  • Sharing eating utensils or drinking glasses.
  • Breastfeeding.
  • Food or water.
  • Casual contact (such as in an office).

Hepatitis B risk factors

A risk factor is something that increases your chances of getting a disease or illness.

Coming in contact with the blood or other body fluids of someone infected with HBV can increase your risk for infection.

Unlike the hepatitis A virus, hep B isn't spread through contaminated food or water.

You may increase your risk of getting hepatitis B if you:

  • Have sex with someone who has hep B.
  • Were born to a mother who had hep B at the time of your birth.
  • Inject illicit drugs, especially with shared needles.
  • Have more than one sexual partner.
  • Live in the same house with someone with hep B — and you share items such as toothbrushes or razors.
  • Have an STD at the time you come in contact with hepatitis B.
  • Travel to areas where hep B is common, such as China, southeast Asia, or sub-Saharan Africa.
  • Received a blood transfusion prior to 1975 (when blood screenings for hep B started).
  • Received a bite that broke the skin, and their saliva entered the wound.

People at risk for hepatitis B include:

  • Those whose jobs involve contact with body fluids, such as:
    • First aid or EMS workers.
    • Funeral directors.
    • Medical staff.
    • Dentists and dental assistants.
    • Firefighters.
    • Police officers.
  • People who work or stay in the hospital or long-term care settings.
  • Hemophiliacs who have many blood transfusions or receive blood products (careful blood screening greatly lowers risk).
  • Hemodialysis patients.

Note: All pregnant women should get a blood test for hepatitis B early in their pregnancy. That's because moms can spread HBV to their babies during birth.

Complications of acute and chronic hepatitis B

Left untreated, hepatitis B can lead to serious problems, including:

  • Chronic swelling of the liver.
  • Cirrhosis (scarring of the liver).
  • Liver cancer.
  • Liver failure.
  • Death (every year, 5,000 people die from liver disease caused by HBV).

Doctors might not detect chronic hep B infection for decades until you become seriously ill from liver disease.

When to see a doctor about hepatitis B

See your doctor if you have yellowing of the skin (jaundice) or abnormal belly pain.

Tests that can help diagnose hep B are:

  • Blood tests - To learn if you have acute or chronic hepatitis B.
  • Liver biopsy - To remove and test a small sample of your liver to check for damage.
  • Liver ultrasound - To show the amount of liver damage.

Hepatitis B Symptoms and Diagnosis

Symptoms appear within 25 to 180 days after HBV exposure.

The most common hepatitis B symptoms are:

  • Jaundice (yellowing of the eyes and skin).
  • Fatigue that lasts for weeks or months.
  • Pain in the upper right side of the stomach near the liver.
  • Loss of appetite.
  • Nausea or throwing up.
  • Joint pain.
  • Low-grade fever.
  • Darker-colored pee.
  • Light-colored stool.
  • Widespread itching.
  • Rash.

Diagnosing and screening for hepatitis B

Talk to your doctor about screening for hep B if you:

  • Are or become pregnant.
  • Live with someone who has the virus.
  • Have had various sexual partners.
  • Have had sex with someone who has hep B.
  • Have a history of STDs.
  • Have HIV or hepatitis C.
  • Are currently on dialysis.
  • Take immunosuppressants after an organ transplant.
  • Inject illegal drugs.

If you're pregnant and have hep B

If you're diagnosed with hepatitis B, be sure that your baby receives the vaccine on the following schedule:

  • 1st dose = within 12 hours of birth.
  • 2nd dose = at one to two months of age.
  • 3rd dose = at six months old.

Your baby should also get a blood test nine to 15 months after birth to be sure they've built up enough protection. Protection is not complete without all three doses of the hep B vaccine.

Hepatitis B Treatment

Treating acute hep B

There's no medicine to treat acute hepatitis virus itself.

If you have severe symptoms, you may need hospital care to treat dehydration and help you rest.

Chronic hep B treatments

For a chronic hepatitis B infection, doctors might not treat it — at least not right away. Most people's immune systems work to keep them healthy without medicine. And medication has side effects.

Whether your doctor treats your chronic hep B infection depends on your choice, age, health status, and liver test results.

Your doctor will take blood about every six months to check liver function. They'll talk to you about drugs to treat hep B at the earliest signs of liver damage.

Interferon drugs to treat chronic hepatitis B

Interferons are man-made versions of proteins your immune system uses to attack viruses.

You'll need to see your doctor for a shot once a week for six months to a year.

This treatment can give your immune system the boost it needs to suppress HBV.

Antiviral drugs for chronic hep B

Antiviral drugs attack the virus, reducing its ability to attack the liver.

You'll need to take these drugs daily for a year or longer.

Liver transplant to treat chronic hepatitis B

In some people, drugs don't work to control their chronic hep B infection. You may qualify for a liver transplant if the disease causes advanced liver damage.

People who get transplants must take anti-rejection medicine for life, so the immune system doesn't reject the new organ. They must also take drugs to prevent hepatitis B from spreading to their new liver.

Lifestyle changes to control chronic hep B

People with a chronic hepatitis B infection should avoid anything that can further damage the liver.

This includes:

  • Alcohol.
  • Illicit drugs.
  • Some over-the-counter and prescription medicines.
  • Some herbal and dietary supplements.

Before taking any herb or drug, check with your doctor to make sure it will not hurt your liver.

About Your Hep B Appointment at the UPMC Center for Liver Diseases

Your PCP can refer you, or you can call us to make an appointment at 412-647-1170 or 1-855-745-4837.

How soon you'll have an appointment depends on:

  • Your symptoms.
  • Any special care your doctor thinks you might need.
  • Your overall health.

Hepatitis B Prevention

You can prevent hepatitis B infection by getting a series of three vaccines during a six-month period.

Also, to help prevent hep B:

  • Use condoms or abstain from sex.
  • Limit your number of sexual partners.
  • Don't inject drugs. If you use IV drugs, get treatment that can help you stop. And never share needles or syringes.
  • Don't share personal items that might have blood on them, such as:
    • Razors.
    • Toothbrushes.
    • Manicuring tools.
    • Pierced earrings.

If you get a tattoo or body piercing, make sure the artist or piercer properly cleans the equipment. You might get infected if the tools have someone else's blood on them.

Health care and public safety workers are at higher risk of hep B.

To best protect themselves, these workers should:

  • Get the hepatitis B vaccine.
  • Cover open cuts or wounds.
  • Always follow routine barrier precautions and safely handle needles and other sharps.
  • Wear gloves when touching or cleaning body fluids on personal items, such as bandages, tampons, or linens.

Preventing the spread of hepatitis B if you have a chronic infection

If you have chronic hep B, you can prevent the spread by:

  • Telling your doctors, dentist, and sexual partner(s) that you have it.
  • Never donating blood, organs, or tissue.
  • Discussing your hep B status with your doctor during pregnancy or before becoming pregnant to ensure your baby receives treatment.