What is Hepatitis B: Risks, Prevention, and Treatment?

Hepatitis B is a viral infection that can cause chronic liver disease and cancer. Vaccination and safe practices are the best prevention.

Infectious Diseases

Hepatitis B: Risks, Prevention, and Treatment

2025-09-04 • Updated 2025-09-17

Overview

Hepatitis B is a viral infection caused by the hepatitis B virus (HBV), which attacks the liver and can cause both acute and chronic disease.
Globally, nearly 300 million people live with chronic hepatitis B, making it one of the most significant infectious causes of death due to its link to cirrhosis and liver cancer.

Unlike hepatitis A, which usually resolves on its own, hepatitis B can persist for life. Vaccination is the most effective tool to prevent infection.

Hepatitis B by the Numbers

300 million people live with chronic hepatitis B worldwide.
820,000 deaths each year are caused by HBV-related complications (WHO, 2024).
90% of newborns infected at birth develop lifelong infection (CDC).
>95% protection provided by vaccination.
99% decline in U.S. child infections since universal newborn vaccination began in 1991 (CDC).
70–80% drop in childhood liver cancer in Taiwan after universal vaccination (NEJM).
0.8% prevalence among vaccinated Aboriginal women in Australia, down from 3.5% (Lancet).

Key Points

Transmitted through blood and bodily fluids (sex, birth, shared needles, medical exposure).
Can cause lifelong infection, cirrhosis, liver failure, and cancer.
The hepatitis B vaccine is highly effective and part of routine childhood immunization in most countries.
Antiviral medications can suppress the virus but usually cannot cure it.
Mother-to-child transmission at birth is a major source of new infections worldwide.

Symptoms

Most acute infections cause few or no symptoms, but when present they may include:

Fatigue
Loss of appetite
Nausea and vomiting
Abdominal pain
Dark urine
Jaundice (yellowing of skin and eyes)

Chronic hepatitis B is often silent until advanced liver disease develops.

Diagnosis

Blood tests detect HBV surface antigen (HBsAg), antibodies, and viral DNA levels.
Liver function tests assess damage.
Ultrasound or elastography may be used to monitor for cirrhosis or liver cancer in chronic cases.

Treatment

Acute infection: Usually supportive care; most adults clear the virus naturally.
Chronic infection: Treated with long-term antiviral medications (e.g., tenofovir, entecavir) to suppress viral replication and reduce complications.
Liver transplant: May be required for advanced cirrhosis or liver failure.

There is currently no complete cure for chronic hepatitis B.

Prevention

Hepatitis B vaccine:
- First given at birth, followed by 2–3 more doses in infancy.
- Provides >95% protection for life.
Screening pregnant women for HBV and giving antivirals if needed reduces mother-to-child transmission.
Safe practices: blood screening, sterile medical equipment, safe sex practices.

Recent Developments

WHO aims to eliminate hepatitis B as a public health threat by 2030 through universal vaccination and improved access to antiviral therapy.
Research is ongoing into curative therapies, including drugs that target the viral reservoir in liver cells.

FAQ

Q: Is hepatitis B curable?
A: Most adults clear the infection naturally if infected. Chronic cases can be controlled with medication, but a complete cure is not yet available.

Q: Can I get hepatitis B more than once?
A: No. Clearing the infection or being vaccinated provides lifelong immunity.

Q: Is the hepatitis B vaccine safe?
A: Yes. The hepatitis B vaccine has been used for decades and is highly safe and effective.

Q: Why is the hepatitis B vaccine given at birth?
A: Newborns infected at birth have up to a 90% chance of developing chronic hepatitis B. Vaccination at birth dramatically reduces that risk.

Q: How common is hepatitis B today?
A: Nearly 300 million people live with chronic hepatitis B worldwide, and around 820,000 people die each year from it.