Hepatitis B Symptoms - Complications, Diagnosing & Tests

Hepatitis B Symptoms

Many people with acute or chronic hepatitis B experience no symptoms, but serious and life-threatening complications can still develop.

Hepatitis B is an inflammation of the liver caused by the hepatitis B virus (HBV). It can be either acute or chronic.

The acute form of the disease typically resolves within a few weeks but can last for up to 6 months, while chronic hepatitis B can last for a lifetime.

According to the World Health Organization (WHO), up to 90 percent of infants infected with HBV within their first year of life will develop chronic hepatitis B, and 30 to 50 percent of children infected before age 6 will develop it.

Fewer than 5 percent of adults infected with HBV develop the chronic form of the disease.

Signs and Symptoms

Not everyone who becomes infected with HBV will develop symptoms, but adults and children over 5 years old are most likely to show signs of acute hepatitis B, according to the Centers for Disease Control and Prevention (CDC).

About 70 percent of adults with acute hepatitis B develop symptoms, which can include:

  1. Fever
  2. Fatigue
  3. Loss of appetite
  4. Nausea and vomiting
  5. Diarrhea
  6. Muscle, joint, or abdominal pain
  7. Dark-colored urine
  8. Clay-colored bowel movements
  9. Jaundice (yellowing of the skin or eyes)

These symptoms appear, on average, from one to three months after exposure to the virus.

Some people with chronic hepatitis B may have ongoing symptoms similar those of acute hepatitis B, but most people experience no symptoms for 20 years or more.

Hepatitis B Complications

In rare cases, acute hepatitis B can cause liver failure, leading to death.

Although chronic hepatitis B often causes no symptoms, about 15 to 25 percent of people with the disease develop serious complications, according to the CDC.

These include cirrhosis (scarring of the liver) and liver cancer.

More than 780,000 people worldwide die from these complications each year, according to the WHO.

Diagnosing Hepatitis B

To determine whether you have hepatitis B, your doctor will first get your medical and symptom history and give you a physical examination.

If your doctor suspects that you may have hepatitis B, he or she will order blood tests to diagnose your condition.

It’s important to note that hepatitis B cannot be distinguished from other forms of hepatitis without laboratory tests.

These tests, which may be done in a series called a panel, look for antigens and antibodies associated with hepatitis B.

An antigen is a substance on the surface of a virus that causes an immune response such as the production of antibodies. Antibodies are substances that the body produces to attack and destroy viruses.

Blood Tests for Hepatitis B

If you test positive for the hepatitis B surface antigen (HBsAg), you have HBV in your blood. You have a chronic infection if you test positive for HBsAg consistently for at least 6 months.

If you test negative for HBsAg but positive for the hepatitis B surface antibody (anti-HBs), you are protected from (immune to) HBV because you've received the vaccine or recovered from an acute infection.

Another test to detect acute hepatitis B looks for the IgG antibody to hepatitis B core antigen (IgG anti-HBc).

Testing positive for the antibody to this antigen — the hepatitis B core antibody (anti-HBc) —means either that you're currently infected with HBV, or that you were in the past, depending on the results of the HBsAg and anti-HBs tests.

The hepatitis B "e" antigen (HBeAg) can only be found in the blood during an active infection and signifies high levels of the virus (and, as a result, signifies being able to spread it easily to other people).

On the other hand, having the hepatitis B "e" antibody (HBeAb or anti-HBe) means that you have chronic hepatitis B but low levels of the virus, and thus a lower risk of complications.

Unlike these antigen and antibody tests, the hepatitis B viral DNA test can directly detect the presence of the virus's DNA in your blood.

Remember that only your doctor can interpret the results of your tests.

Sanjai Sinha, MD

Medical Reviewer
Sanjai Sinha, MD, is a board-certified internal medicine physician and an assistant professor of clinical medicine and the director of the care management program at Weill Cornell Medical College. Helping patients understand health information and make informed decisions, and communicating health topics effectively both in person and through patient educational content, is a challenge that animates his daily life, and something he is always working to improve.

Dr. Sinha did his undergraduate training at the University of California in Berkeley, where he graduated magna cum laude. He earned his medical degree at the Albert Einstein College of Medicine in New York City in 1998 and completed his internship and residency training at the New York University School of Medicine in 2001. Subsequently, he worked with the Department of Veterans Affairs from 2001 to 2012 and held faculty appointments at both the Mount Sinai School of Medicine and Columbia University College of Physicians and Surgeons.

In 2006, he won the VISN3 Network Director Award for Public Service and a commendation from the secretary of Veterans Affairs for his relief work after Hurricane Katrina. He joined Weill Cornell Medical College in 2012, where he is an assistant professor of clinical medicine and the director of the care management program, as well as a practicing physician.

In addition to his work for Everyday Health, Sinha has written for various publications, including Sharecare and Drugs.com; published numerous papers in peer-reviewed medical journals, such as the Journal of General Internal Medicine; and presented at national conferences on many healthcare delivery topics. He is a fellow of the American College of Physicians.

Joseph Bennington-Castro

Author

Joseph Bennington-Castro is a science writer based in Hawaii. He has written well over a thousand articles for the general public on a wide range topics, including health, astronomy, archaeology, renewable energy, biomaterials, conservation, history, animal behavior, artificial intelligence, and many others.

In addition to writing for Everyday Health, Bennington-Castro has also written for publications such as Scientific American, National Geographic online, USA Today, Materials Research Society, Wired UK, Men's Journal, Live Science, Space.com, NBC News Mach, NOAA Fisheries, io9.com, and Discover.

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