Overview

Hepatitis B is a viral infection that affects the liver and is caused by the hepatitis B virus (HBV). It is one of the most common viral liver infections worldwide. Once the virus enters the body, it travels through the bloodstream to the liver, where it infects liver cells and begins to multiply.

In many individuals, the infection initially causes few or no symptoms. However, the body’s immune response to the virus can lead to liver inflammation. If hepatitis B is not identified and managed early, it may progress over time and result in serious complications such as liver cirrhosis, liver failure, or liver cancer.

Globally, several hundred million people are estimated to be living with chronic hepatitis B infection.

Acute and Chronic Hepatitis B

Hepatitis B infection is classified based on duration:

• Acute hepatitis B refers to infection during the first six months after exposure.
• Chronic hepatitis B is diagnosed when hepatitis B surface antigen (HBsAg) remains detectable in the blood beyond six months.

Signs and Symptoms

Symptoms of Acute Hepatitis B

Some individuals develop symptoms several weeks after infection, while others remain completely asymptomatic. When present, symptoms may include:

• Loss of appetite
• Nausea or vomiting
• Fatigue
• Abdominal discomfort
• Muscle or joint pain
• Yellowing of the eyes or skin (jaundice)

In rare cases, acute hepatitis B can cause sudden and severe liver injury, leading to acute liver failure. This is a medical emergency requiring immediate care.

Symptoms of Chronic Hepatitis B

Many people with chronic hepatitis B have no noticeable symptoms for long periods. When symptoms do occur, they may include:

• Persistent tiredness
• Upper abdominal discomfort (right side)
• Nausea
• Reduced appetite
• Joint or muscle aches
• Mood changes such as irritability or low mood

Chronic hepatitis B significantly increases the risk of developing liver cirrhosis and liver cancer, even in the absence of symptoms. Regular follow-up is therefore essential.

Diagnosis of Hepatitis B

Hepatitis B is diagnosed through blood tests.

HBsAg Test

The hepatitis B surface antigen (HBsAg) test confirms whether the virus is present in the body.

Additional Blood Tests

Further tests may be performed to:

• Assess viral activity
• Evaluate liver enzyme levels
• Determine the degree of liver inflammation or damage

These results help guide treatment decisions and monitoring frequency.

Treatment of Hepatitis B

Not all individuals with hepatitis B require immediate treatment.

• People with immunity or normal liver function tests usually do not need treatment but require monitoring.
• Patients with evidence of active liver damage or high viral activity may require antiviral therapy.

Treatment decisions are complex and should be made in consultation with a liver specialist.

Antiviral Medications

Hepatitis B is commonly treated with long-term oral antiviral medications, which help suppress viral replication and reduce liver damage. Commonly used medicines include:

• Tenofovir
• Entecavir
• Lamivudine
• Adefovir

These medications are generally well tolerated. However, long-term use may occasionally lead to antiviral resistance, where the virus becomes less responsive to treatment. Regular blood tests are used to detect this early and adjust therapy if needed.

The primary goal of treatment is viral suppression, not cure. Complete elimination of hepatitis B virus is uncommon, but effective control significantly reduces the risk of cirrhosis and liver cancer.

Prevention and Lifestyle Measures

Hepatitis B is preventable through vaccination and safe practices.

Key Prevention Measures

• Vaccination against hepatitis B
• Practising safe sex
• Avoiding sharing needles or syringes
• Not sharing personal items such as razors or toothbrushes
• Using sterile equipment for injections, tattoos, or piercings
• Covering open wounds
• Proper handling and disposal of blood-contaminated materials

People exposed to hepatitis B who are not vaccinated should receive hepatitis B immunoglobulin (HBIG) and the vaccine as soon as possible, ideally within days of exposure.

Living With Hepatitis B

Many individuals with hepatitis B lead normal lives with appropriate monitoring and treatment. Maintaining liver health involves:

• Avoiding or limiting alcohol
• Eating a balanced diet
• Regular physical activity
• Avoiding smoking
• Attending scheduled follow-up visits

Early detection and consistent care play a critical role in preventing long-term complications.

Hepatitis B Care Under Dr. Saurabh Singhal

Evaluation and management of hepatitis B are provided under the supervision of Dr. Saurabh Singhal, Director & Head – Centre for Liver-GI Diseases & Transplantation (CLDT), at Aakash Healthcare, Dwarka, New Delhi.

Care focuses on:

• Accurate diagnosis and staging of disease
• Evidence-based antiviral treatment
• Regular monitoring for liver fibrosis or cirrhosis
• Prevention of liver failure and liver cancer
• Long-term liver health and patient education

Frequently Asked Questions (FAQs)

What is chronic hepatitis B?

Chronic hepatitis B is a long-term infection caused by the hepatitis B virus that affects the liver.

Is chronic hepatitis B serious?

Many people live well with chronic hepatitis B. However, if untreated, it can lead to cirrhosis or liver cancer over time.

How does hepatitis B spread?

It can spread from mother to baby at birth, through unprotected sex, shared needles, contaminated blood transfusions, or shared personal items that contact blood.

How is hepatitis B diagnosed?

A blood test detecting HBsAg confirms infection. Additional tests assess disease activity and liver health.

Can hepatitis B be prevented?

Yes. Vaccination is highly effective in preventing hepatitis B infection.

Conclusion

Hepatitis B is a common but manageable liver disease. With early diagnosis, appropriate antiviral therapy, and regular monitoring, most patients can prevent serious liver complications and maintain good quality of life.

Timely consultation with a liver specialist is essential for long-term liver protection and disease control.