Patient education: Hepatitis B (The Basics)

What is hepatitis B? — 

This 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).

Hepatitis B is caused by a virus. 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 some people first get hepatitis B (called "acute" hepatitis B), they can:

●Feel like they have the flu

●Have nausea

●Have pain in the upper right side of the belly

●Have yellowing of the eyes or skin (called "jaundice")

These symptoms usually get better, but it can take weeks to months.

For most people with hepatitis B, their liver damage gets better within about 6 months. But 1 out of every 20 adults who gets hepatitis B has 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 buildup in the lungs

●Bruising or bleeding easily

●Trouble breathing

●Feeling full

●Confusion that can start suddenly

●Coma

Chronic hepatitis B also increases the risk of getting liver cancer.

How did I get hepatitis B? — 

There are a few ways to catch the hepatitis B virus. They all involve mixing bodily fluids with other people.

You might have caught hepatitis B 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

A pregnant person can also pass hepatitis B on to their baby. This is especially likely if they are from a country where hepatitis B is common.

Is there a test for hepatitis B? — 

Yes. If your doctor or nurse thinks you have hepatitis B based on your symptoms, they will do blood tests to check for the infection.

Most people should be checked, or "screened," for hepatitis B at least once in their lifetime, even if they do not have symptoms. This is because many people do not know if they have been exposed. Blood tests can also show if you had hepatitis B in the past, even if the infection got better on its own.

Some people need to be tested for hepatitis B more often. For example, your doctor might suggest this if you did not get a hepatitis B vaccine and you are at higher risk for getting the virus. People at higher risk include those who:

●Share drugs or needles with others

●Have sex with multiple partners, and do not use condoms

Your doctor might also want to do tests to see if your liver is damaged. This can involve blood tests or tests to measure your liver's stiffness. You might also 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 shows 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 B, 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 you do not need to start treatment yet, they will monitor you over time. This involves doing regular blood tests. If the tests show the virus is doing more damage to your liver, or if you start having new symptoms, you might start medicine then.

For people who 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 is an imaging test that creates pictures of the inside of the body.) This is to make sure you are not developing liver cancer.

How can I protect my liver if I have chronic hepatitis B? — 

There are several things you can do. You can:

●Avoid alcohol

●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 can sometimes damage the liver.

How can I prevent spreading hepatitis B to other people? — 

If you have active hepatitis B infection, you can reduce your chances of spreading the virus if you:

●Make sure your family and close friends get tested and get the vaccine for hepatitis B.

●Use a latex condom correctly every time you have sex (figure 2).

●Do not share razors, toothbrushes, or anything that might have blood on it.

●Do not share needles or syringes.

●Use bandages to cover cuts and open sores.

●Clean drops of your blood off things with a mixture of bleach and water – For the mixture, use 9 times more water than bleach.

People with hepatitis B can still safely hug and kiss, as well as share cups or eating utensils. Hepatitis B is also not spread through coughing or sneezing.

Is there a vaccine for hepatitis B? — 

Yes. All babies should get a hepatitis B vaccine. Most adults should also get vaccinated. If you were not vaccinated as a baby, or if you are not sure if you were, talk to your doctor or nurse. They can help you decide if you should get a vaccine now.

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. You might need treatment with medicine for several months before giving birth. In addition, when you give birth, your baby should get special shots right away. These help protect your baby from infection. Your baby will also get a vaccine shot at 1 or 2 months old, and another one at 6 months. They will get a test between 9 and 12 months to see if they have hepatitis B. Your doctor will decide if they need more vaccine shots at that time.

More on this topic

Patient education: Cirrhosis (The Basics)
Patient education: Hepatitis A (The Basics)
Patient education: Hepatitis C (The Basics)
Patient education: Viral hepatitis panel (The Basics)
Patient education: Liver panel (The Basics)
Patient education: Aminotransferase tests (The Basics)
Patient education: Liver transplant (The Basics)

Patient education: Cirrhosis (Beyond the Basics)
Patient education: Hepatitis A (Beyond the Basics)
Patient education: Hepatitis B (Beyond the Basics)