Symptoms

Most people who have an acute hepatitis B infection don't have symptoms. But if you do have symptoms, they may include:

• Extreme tiredness (fatigue).
• Mild fever.
• Headache.
• Loss of appetite, nausea, and vomiting.
• Constant discomfort on the right side of the belly under the rib cage. (That's where the liver is located.)
• Diarrhea or constipation.
• Muscle aches or joint pain.
• Skin rash.
• Jaundice. This means that the skin and whites of the eyes look yellow. Jaundice is a major sign of liver damage. It usually appears after other symptoms have started to go away.

Most people with chronic infection have no symptoms.

You may get infected without knowing it. You may not find out that you have an infection until you have a routine blood test or donate blood. Finding out that a family member or someone you live with is infected also may cause you to be tested. Some people never know they have hepatitis B until a doctor finds that they have cirrhosis or liver cancer.

What Happens

Most people with hepatitis B have an acute (short-term) infection.

• They start to feel better after 2 to 3 weeks and recover completely after 4 to 8 weeks. They develop antibodies to hepatitis B. These antibodies provide lifelong protection against future infection.
• Only some people (mainly older adults) have long-lasting symptoms.
• A small number of people have symptoms that last for months and sometimes years.

If you stay infected with the virus for 6 months or longer, you have a chronic infection.

The risk of having chronic infection is related to the age at which you first become infected. The risk is highest for newborns infected at birth and children up to age 5.

Many people with chronic hepatitis B won't develop complications. But about 15 to 25 out of 100 people with chronic infection will die of cirrhosis or liver cancer.¹ (This means that 75 to 85 people out of 100 who have a chronic infection won't die of these diseases.) Having a lot of virus in the body (a high viral load) increases the risk of getting cirrhosis and liver cancer.

• You are more likely to get cirrhosis if you carry a certain hepatitis B antigen, are older than 40, and have high liver enzymes. For more information, see the topic Cirrhosis.
• Risk factors for getting liver cancer after chronic infection include being male, having a family history of liver cancer, being over 40 years old, having cirrhosis, and also having hepatitis C.

Hepatitis D (delta) virus infection is a problem that can develop in relation to hepatitis B infection, but it's not common. It occurs only in those with hepatitis B. And it may make that infection more severe.

People with hepatitis B who engage in high-risk behavior (such as having multiple sex partners or injecting illegal drugs) are at increased risk for hepatitis C. They also are at higher risk of getting HIV, the virus that causes AIDS.