Living with Hepatitis B: FAQ

Will I recover from a hepatitis B infection?

What is the difference between acute and chronic hepatitis B?

How can I prevent spreading hepatitis B to others?

Will I become sick if I have acute hepatitis B?

How will I know when I have recovered from an acute hepatitis B infection?

What should I do if I have been diagnosed with chronic hepatitis B?

What tests will be used to monitor my chronic hepatitis B?

Is there a cure for chronic hepatitis B?

Are there any approved drugs to treat chronic hepatitis B?

If I have a chronic hepatitis B infection, should I be on medication?

What advice do you have for those living with chronic hepatitis B?

Can I donate blood if I have hepatitis B?

Will I recover from a hepatitis B infection?

The answer depends on whether you are infected as an adult, a child, or a baby. Most infected adults will recover without any problems, but unfortunately, most infected babies and children will develop chronic hepatitis B infections.

Adults – 90% will get rid of the virus and recover without any problems; 10% will develop chronic hepatitis B.
Young Children – 40% will get rid of the virus and recover without problems; 60% will develop a chronic hepatitis B infection.
Infants – 90% will become chronically infected; only 10% will be able to get rid of the virus.

What is the difference between an "acute" and a "chronic" hepatitis B infection?

A hepatitis B infection is considered to be “acute” during the first 6 months after being exposed. This is the average period of time it takes to recover from a hepatitis B infection. If you still test positive for the hepatitis B virus (HBsAg+) after 6 months, you are considered to have a "chronic" hepatitis B infection, which can last a lifetime.

How can I prevent spreading hepatitis B to others?

If you are infected, you can pass the virus on to others and it is important to take certain precautions to prevent this from happening. Sexual partners and those living in close household contact should be tested for hepatitis B and receive the hepatitis B vaccine, which can protect them for a lifetime! Babies born to women who are infected with hepatitis B must be vaccinated in the delivery room or within the first 12 hours of life.

In addition, it is important to keep all cuts covered and avoid sharing any sharp instruments such as razors, toothbrushes, or earrings, etc., since small amounts of blood can be exchanged through these items. Hepatitis B is not transmitted casually and it cannot be spread through sneezing, coughing, hugging or eating food prepared by someone who is infected with HBV.

Will I become sick if I have acute hepatitis B?

Hepatitis B is considered a "silent infection” because it often does not cause any symptoms. Most people feel healthy and do not know they have been infected, which means they can unknowingly pass the virus on to others. Other people may have mild symptoms such as fever, fatigue, joint or muscle pain, or loss of appetite that are mistaken for the flu. Less common but more serious symptoms include severe nausea and vomiting, yellow eyes and skin (called “jaundice”), and a swollen stomach - these symptoms require immediate medical attention and a person may need to be hospitalized.

How will I know when I have recovered from an "acute" hepatitis B infection?

Once your doctor has confirmed through a blood test that you have successfully cleared the virus from your system and developed the protective antibodies (HBsAb+), you will be protected from any future hepatitis B infection and are no longer contagious to others.

What should I do if I am diagnosed with chronic
hepatitis B?

If you test positive for the hepatitis B virus for longer than 6 months, this indicates that you have a chronic hepatitis B infection. You should make an appointment with a hepatologist (liver specialist) or gastroenterologist familiar with hepatitis B. This specialist will order blood tests and possibly a liver ultrasound to evaluate your hepatitis B status and the health of your liver. Your doctor will probably want to see you at least once or twice a year to monitor your hepatitis B and determine if you would benefit from treatment.

Most people chronically infected with hepatitis B can expect to live long, healthy lives. Once you are diagnosed with chronic hepatitis B, the virus may stay in your blood and liver for a lifetime. It is important to know that you can pass the virus along to others, even if you don’t feel sick. This is why it’s so important that you make sure that all close household contacts and sex partners are tested and vaccinated against hepatitis B.

What tests will be used to monitor my hepatitis B?

Common tests used by doctors to monitor your hepatitis B include the hepatitis B blood panel, liver function tests (ALT), hepatitis B e-Antigen (HBeAg), hepatitis B e-Antibody (HBeAb), ultrasound and imaging, and possibly liver biopsy before starting treatment.

Is there a cure for chronic hepatitis B?

Right now, there is no cure for chronic hepatitis B, but the good news is there are new treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus, although this is not common.

With all of the new exciting research, there is great hope that a complete cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development.

Are there any approved drugs to treat chronic hepatitis B?

Yes, there are currently five approved treatments for hepatitis B in the United States. They are:

Intron A (interferon alpha) is given by injection several times a week for six months to a year, or sometimes longer. The drug can cause side effects such as flu-like symptoms, depression, and headaches.
Pegasys (pegylated interferon) is given by injection once a week usually for six months to a year. The drug can cause side effects such as flu-like symptoms, depression and other mental health problems. Approved May 2005 and available only for adults.
Epivir-HBV (lamivudine) is a pill that is taken once a day, with almost no side effects, for at least one year or longer. A primary concern is the possible development of hepatitis B virus mutants during and after treatment.
Hepsera (adefovir-dipivoxil) is a pill taken once a day, with few side effects, for at least one year or longer. The primary concern is that kidney problems can occur while taking the drug.
Baraclude (entecavir) is a pill taken once a day, with almost no side effects for up to one year. It is considered to be the most potent oral antiviral drug for chronic hepatitis B to date. Approved April 2005 and available only for adults. Pediatric clinical trials may be planned for the future.

Although they do not provide a complete cure, except in rare cases (a "cure" means that a person loses the hepatitis B virus and develops protective surface antibodies), they do slow down the virus and decrease the risk of more serious liver disease later in life.

If I have a chronic hepatitis B infection, should I be on medication?

It is important to understand that not every person with chronic hepatitis B needs to be on medication. You should talk to your doctor about whether you are a good candidate for drug therapy or a clinical trial. Be sure that you understand the pros and cons of each treatment option. Whether you decide to start treatment or not, you should be seen regularly by a liver specialist or a doctor knowledgeable about hepatitis B.

What advice do you have for those living with chronic hepatitis B?

We strongly recommend avoiding alcohol, as it can be extremely harmful to a liver already infected with the hepatitis B virus. Additionally, you should avoid smoking for the same reason. You should be sure to talk to your doctor before taking any prescription, over the counter medication, or herbal remedies.

Although there is no special diet for people who have chronic hepatitis B, a healthy, well-balanced diet that is low-fat and includes plenty of vegetables is recommended. You may want to avoid eating raw shellfish, since they can contain bacteria that are harmful to your liver.

Can I donate blood if I have hepatitis B?

No. The blood bank will not accept any blood that has been exposed to hepatitis B, even if you have recovered from an acute infection.