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Hepatitis B

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Hepatitis B is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness. It results from infection with the Hepatitis B virus. Hepatitis B can be either “acute” or “chronic.”

Acute Hepatitis B virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis B virus. Acute infection can — but does not always — lead to chronic infection.

Chronic Hepatitis B virus infection is a long-term illness that occurs when the Hepatitis B virus remains in a person’s body.

Although a majority of adults develop symptoms from acute Hepatitis B virus infection, many young children do not. Adults and children over the age of 5 years are more likely to have symptoms. Seventy percent of adults will develop symptoms from the infection.

Symptoms of acute Hepatitis B, if they appear, can include:
  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Dark urine
  • Clay-colored bowel movements
  • Joint pain
  • Jaundice (yellow color in the skin or the eyes) 
Most individuals with chronic Hepatitis B remain symptom free for as long as 20 or 30 years. About 15%–25% of people with chronic Hepatitis B develop serious liver conditions, such as cirrhosis (scarring of the liver) or liver cancer. Even as the liver becomes diseased, some people still do not have symptoms, although certain blood tests for liver function might begin to show some abnormalities.

Hepatitis B is spread when blood, semen, or other body fluid infected with the Hepatitis B virus enters the body of a person who is not infected. People can become infected with the virus during activities such as:
  • Birth (spread from an infected mother to her baby during birth)
  • Sex with an infected partner
  • Sharing needles, syringes, or other drug-injection equipment
  • Sharing items such as razors or toothbrushes with an infected person
  • Direct contact with the blood or open sores of an infected person
  • Exposure to blood from needlesticks or other sharp instruments
Many people with chronic Hepatitis B virus infection do not know they are infected since they do not feel or look sick. However, they still can spread the virus to others and are at risk of serious health problems themselves.

Among adults in the United States, Hepatitis B is most commonly spread through sexual contact and accounts for nearly two-thirds of acute Hepatitis B cases. In fact, Hepatitis B is 50–100 times more infectious than HIV.

Although anyone can get Hepatitis B, some people are at greater risk, such as those who: 
  • Have sex with an infected person
  • Have multiple sex partners
  • Have a sexually transmitted disease
  • Are men who have sexual contact with other men
  • Inject drugs or share needles, syringes, or other drug equipment
  • Live with a person who has chronic Hepatitis B
  • Are infants born to infected mothers
  • Are exposed to blood on the job
  • Are hemodialysis patients
  • Travel to countries with moderate to high rates of Hepatitis B
There are many different blood tests available to diagnose Hepatitis B. They can be ordered as an individual test or as a series of tests. Ask your health professional to explain what he or she hopes to learn from the tests and when you will get the results.

There is no medication available to treat acute Hepatitis B. During this short-term infection, doctors usually recommend rest, adequate nutrition, and fluids, although some people may need to be hospitalized.

People with chronic Hepatitis B virus infection should seek the care or consultation of a doctor with experience treating Hepatitis B. This can include some internists or family medicine practitioners, as well as specialists such as infectious disease physicians, gastroenterologists, or hepatologists (liver specialists). People with chronic Hepatitis B should be monitored regularly for signs of liver disease and evaluated for possible treatment. Several medications have been approved for Hepatitis B treatment, and new drugs are in development. However, not every person with chronic Hepatitis B needs to be on medication, and the drugs may cause side effects in some patients.

The best way to prevent Hepatitis B is by getting the Hepatitis B vaccine. The Hepatitis B vaccine is safe and effective and is usually given as 3-4 shots over a 6-month period.

The Hepatitis B vaccine series is a sequence of shots that stimulate a person’s natural immune system to protect against HBV. After the vaccine is given, the body makes antibodies that protect a person against the virus. An antibody is a substance found in the blood that is produced in response to a virus invading the body. These antibodies are then stored in the body and will fight off the infection if a person is exposed to the Hepatitis B virus in the future.

Hepatitis B vaccination is recommended for: 
  • All infants, starting with the first dose of Hepatitis B vaccine at birth
  • All children and adolescents younger than 19 years of age who have not been vaccinated
  • People whose sex partners have Hepatitis B
  • Sexually active persons who are not in a long-term, mutually monogamous relationship.
  • Persons seeking evaluation or treatment for a sexually transmitted disease
  • Men who have sexual contact with other men
  • People who share needles, syringes, or other drug-injection equipment
  • People who have close household contact with someone infected with the Hepatitis B virus
  • Health care and public safety workers at risk for exposure to blood or blood-contaminated body fluids on the job
  • People with end-stage renal disease, including predialysis, hemodialysis, peritoneal dialysis, and home dialysis patients
  • Residents and staff of facilities for developmentally disabled persons
  • Travelers to regions with moderate or high rates of Hepatitis B
  • People with chronic liver disease
  • People with HIV infection
  • Anyone who wishes to be protected from Hepatitis B virus infection