Commentary on Hepatitis-B’s Symptoms, Causes, and Treatment

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Hepatitis B is a liver infection caused by the hepatitis B virus (HBV), a major global health concern due to its potential to become chronic, leading to liver cirrhosis, liver failure, or cancer. It spreads through contact with infected bodily fluids, such as blood or saliva. While some people clear acute infections naturally, others develop chronic hepatitis B, particularly if infected at a young age. Chronic carriers face higher risks of serious liver diseases. Over 296 million people globally live with chronic HBV, and vaccination remains the most effective preventive measure alongside safe medical and personal practices.

Hepatitis B is spread mainly through infected blood or body fluids. Key routes include mother-to-child transmission, horizontal transmission (infected child’s blood exposure to a healthy child), unprotected sexual contact, and sharing needles. Healthcare workers also face risks when exposed to contaminated blood. Unlike hepatitis A, HBV is not transmitted via casual contact or food. Preventive measures include safe medical practices and vaccination, especially for high-risk individuals.

Hepatitis B symptoms range from mild to severe, including fatigue, nausea, abdominal pain, dark urine, joint pain, and jaundice. While many acute cases are asymptomatic, chronic infections may remain undetected until serious complications arise. Chronic carriers risk cirrhosis, liver failure, and liver cancer, underscoring the need for regular liver monitoring through tests and HBV DNA assessments.

Hepatitis B testing involves three main blood tests: the hepatitis B surface antigen (HBsAg) test to detect active infection, the hepatitis B core antibody (anti-HBc) test to confirm past infection, and the hepatitis B surface antibody (anti-HBs) test to check for immunity, either from vaccination or previous infection. A positive HBsAg test indicates current infection, while a positive anti-HBc test shows past exposure to the virus. A positive anti-HBs test means the person is immune to HBV. If HBsAg remains positive for more than six months, the infection is considered chronic. People at higher risk—such as those with a history of unprotected sex, injection drug users, healthcare workers, pregnant women, and individuals with certain medical conditions—should get tested. Vaccination can still be given to people with prior infection or vaccination history, even if screening isn’t available.

Acute hepatitis B often requires only supportive care, while chronic hepatitis B can be managed with antiviral medications like tenofovir or entecavir, which suppress viral activity to prevent liver damage. Although not curative, these medications control disease progression. In advanced cases, liver transplantation may be necessary. Regular monitoring for chronic patients is essential to detect liver disease or cancer early.

Vaccination is the most effective prevention for hepatitis B, typically administered in three doses, providing over 95% protection. Infants, especially at birth, are prioritized to prevent transmission from infected mothers. Other preventive measures include safe sex practices, avoiding needle sharing, and ensuring sterile medical equipment. For healthcare workers, protective gear and proper needle handling reduce exposure.

Guidelines for the prevention, diagnosis, care and treatment for people with chronic hepatitis B infection. Geneva: World Health Organization; 2024. Licence: CC BYNC-SA 3.0 IGO.

Link: https://www.who.int/publications/i/item/9789240090903

CDC.Clinical testing and diagnosis for. Hepatitis B. https://www.cdc.gov/hepatitis-b/hcp/diagnosis-testing/index.html