Hepatitis B is inflammation (irritation and swelling) of the liver due to the hepatitis B virus (HBV).

Other types of hepatitis include:

• Hepatitis A
• Hepatitis C
• Hepatitis D

See also:

• Autoimmune hepatitis
• Chronic persistent hepatitis
• Drug-induced hepatitis

The hepatitis B virus spreads through blood and other body fluids. Infection can occur if you have:

• Blood transfusions
• Contact with blood in healthcare settings
• Received a tattoo or acupuncture with contaminated instruments
• Shared needles during drug use
• Unsafe sex with an infected person

The hepatitis B virus can be passed to an infant during childbirth or shortly thereafter if the mother is infected.

The risk of becoming chronically infected depends on your age at the time of infection. Most newborns and about 50% of children infected with hepatitis B develop chronic hepatitis. Only a few adults infected with HBV develop the chronic condition.

Most of the damage from hepatitis B virus is due to by the body's response to the infection. When the body's immune system detects the infection, it sends out special cells to fight it off. However, these disease-fighting cells can lead to liver inflammation. The liver damage also interferes with the body's ability to get rid of bilirubin, a breakdown product of old red blood cells). This leads to jaundice (yellow discoloration of the eyes and body) and dark urine.

It takes about 1-6 months from the time of infection until symptoms of acute hepatitis appear. Early symptoms may include:

• Appetite loss
• Fatigue
• Low-grade fever
• Muscle and joint aches
• Nausea and vomiting
• Yellow skin and dark urine due to jaundice

The following tests are done to help diagnose hepatitis B:

• Albumin level (may be low)
• Hepatitis B antibody panel
• Liver function tests
• Prothrombin time (may be increased due to severe liver failure)

Acute hepatitis needs no treatment other than careful monitoring of liver function, which involves blood tests. In the rare cases that you develop liver failure, you should be monitored in a hospital intensive care unit (ICU) until you recover or a liver transplant becomes necessary. A liver transplant is the only cure in cases of liver failure.

Liver damage makes it harder for the liver to break down proteins, so protein intake should be restricted. Medications will be given to limit protein production by bacteria in the body.

Chronic hepatitis treatment involves medications to treat infections and reduce inflammation and other symptoms. Liver transplantation is used to treat end-stage chronic hepatitis B liver disease.

For more information on treatment, see: Liver disease

See: Liver disease support group

The acute illness usually goes away after 2 to 3 weeks, and the liver usually returns to normal within about 4 months.

Some infected people develop chronic hepatitis.

Hepatitis B is deadly in approximately 1% of cases.

There is a higher rate of hepatocellular carcinoma in those who have had hepatitis B than in the general population.

Other complications may include:

• Chronic persistant hepatitis
• Cirrhosis

Call your health care provider if symptoms of hepatitis B develop.

Call for an appointment with your health care provider if hepatitis B symptoms do not go away in 2 or 3 weeks, or if new symptoms develop.

Call your provider if you belong to a high risk group for hepatitis B and have not yet received the HBV vaccine.

People who are at high risk, including health care workers and those who live with someone with hepatitis B, should get the hepatitis B vaccine. TheUnited States Public Health Service has recommended that all newborns and children who have not yet enter puberty receive the vaccine. Infants born of mothers who either currently have acute hepatitis B or who have had the infection receive a special vaccination that includes given hepatitis B immune globulin and a hepatitis B immunization within 12 hours of birth.

Screening of all donated blood has reduced the chance of getting hepatitis B from a blood transfusion. Mandatory reporting of the disease allows state health care workers to track people who have been exposed to the virus and to give the vaccine to those who have not yet developed the disease.

Avoid sexual contact with a person who has acute or chronic hepatitis B. Condoms, if used consistently and properly, may also reduce your risk of developing this condition.

Lin KW. Hepatitis B. Am Fam Physician. 2004; 69(1): 75-82.

Goldman L, Ausiello D. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007.