Hepatitis B is a vaccine-preventable liver infection caused by the hepatitis B virus (HBV). Hepatitis B is spread when blood, semen, or other body fluids from a person infected with the virus enters the body of someone who is not infected. This can happen through sexual contact; sharing needles, syringes, or other drug-injection equipment; or from mother to baby at birth. Not all people newly infected with HBV have symptoms, but for those that do, symptoms can include fatigue, poor appetite, stomach pain, nausea, and jaundice. For many people, hepatitis B is a short-term illness. For others, it can become a long-term, chronic infection that can lead to serious, even life-threatening health issues like cirrhosis or liver cancer. Risk for chronic infection is related to age at infection: about 90% of infants with hepatitis B go on to develop chronic infection, whereas only 2%–6% of people who get hepatitis B as adults become chronically infected. The best way to prevent hepatitis B is to get vaccinated.

HBV is transmitted through activities that involve percutaneous (i.e., puncture through the skin) or mucosal contact with infectious blood or body fluids (e.g., semen and saliva), including

  • sex with an infected partner;
  • injection-drug use that involves sharing needles, syringes, or drug-preparation equipment;
  • birth to an infected mother;
  • contact with blood from or open sores on an infected person;
  • exposures to needle sticks or sharp instruments; and
  • sharing certain items with an infected person that can break the skin or mucous membranes (e.g., razors, toothbrushes, and glucose monitoring equipment), potentially resulting in exposure to blood.

Not all people with acute HBV infection have symptoms. The presence of signs and symptoms varies by age. Most children <5 years of age and newly infected immunosuppressed adults are generally asymptomatic, whereas 30%–50% of people age ≥5 years have signs and symptoms (6). When present, signs and symptoms of acute HBV infections can include

  • fever,
  • fatigue,
  • loss of appetite,
  • nausea,
  • vomiting, 
  • abdominal pain,
  • dark urine,
  • clay-colored stool,
  • joint pain, and
  • jaundice.

Most people with chronic HBV infection are asymptomatic and have no evidence of liver disease or injury. However, some people develop chronic hepatitis (elevation of AST/ALT), cirrhosis, or hepatocellular carcinoma (i.e., primary liver cancer).

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