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Symptoms and Signs of Hepatitis B (HBV, Hep B)

Doctor's Notes on Hepatitis B
(HBV, Hep B)

Hepatitis B is a liver disease caused by infection with the hepatitis B virus. The infection is spread from person to person through sexual contact, contact with contaminated blood (for example, through shared needles from intravenous drug abuse), and from mother to child.

Most healthy adults do not develop symptoms after the initial hepatitis B infection. If they do develop symptoms, the signs and symptoms of acute hepatitis B infection can include jaundice (yellowish discoloration of the skin and whites of the eyes), fatigue, nausea, loss of appetite, and pain in the upper right side of the abdomen. Some people develop a chronic (long-term) hepatitis B infection. Associated symptoms and signs of chronic infection can include weakness, weight loss, cirrhosis (scarring) of the liver, problems with blood clotting, a rash on the palms, and breast enlargement in men.

Medical Author:
Medically Reviewed on 3/11/2019

Hepatitis B
(HBV, Hep B) Symptoms

Half of all people infected with the hepatitis B virus have no symptoms and may never realize that they have been infected. Adults are more likely to develop symptoms than children. For those who do get sick, symptoms usually develop within 1 to 4 months after exposure to the virus. The initial symptoms are often similar to the flu.

Common symptoms of hepatitis B include:

  • Appetite loss
  • Feeling tired (fatigue)
  • Nausea and vomiting
  • Itching all over the body
  • Pain over the location of the liver (on the right side of the abdomen, under the lower rib cage)
  • Jaundice (a condition in which the skin and the whites of the eyes turn yellow in color)
  • Dark urine (the color of cola or tea)
  • Pale-colored stools (grayish or clay colored)

Other types of acute viral hepatitis such as hepatitis A and hepatitis C have symptoms that are indistinguishable from hepatitis B.

Fulminate hepatitis is a severe form of acute hepatitis that can be life-threatening if not treated right away. Fortunately, fulminate hepatitis is rare. The symptoms of fulminate hepatitis develop very suddenly and may include:

Prolonged nausea and vomiting can cause dehydration. Individuals with dehydration may notice these symptoms:

  • Extreme weakness
  • Confusion or trouble concentrating
  • Headache
  • Lack of urination
  • Irritability

Symptoms of liver damage may include the following:

  • Fluid retention causing swelling of the belly (ascites) and sometimes the legs
  • Weight gain due to ascites
  • Persistent jaundice
  • Loss of appetite, weight loss, wasting
  • Vomiting with blood in the vomit
  • Bleeding from the nose, mouth, or rectum; or blood in the stool
  • Hepatic encephalopathy (excessive sleepiness, mental confusion, and in advanced stages, development of coma)

Hepatitis Surprising Things That Can Damage Your Liver Slideshow

Hepatitis Surprising Things That Can Damage Your Liver Slideshow

Too much sugar isn't just bad for your teeth. It can harm your liver, too. The organ uses one type of sugar, called fructose, to make fat. Too much refined sugar and high-fructose corn syrup causes a fatty buildup that can lead to liver disease. Some studies show that sugar can be as damaging to the liver as alcohol, even if you're not overweight. It's one more reason to limit foods with added sugars, such as soda, pastries, and candy.


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.