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| Hepatitis B |
Hepatitis B is a viral infection that affects the liver.
Some people develop a short-term infection and recover completely. Others develop chronic hepatitis B, which can persist for years and increase the risk of cirrhosis, liver failure and liver cancer.
One of the most important things to understand about hepatitis B is that many infected people have no symptoms. A person can therefore carry and transmit the virus without knowing they have it.
The good news is that hepatitis B is preventable with a highly effective vaccine, can be detected with blood tests and, when chronic infection requires treatment, antiviral medicines can substantially reduce the risk of serious liver disease.
What Is Hepatitis B?
Hepatitis B is caused by the hepatitis B virus (HBV).
HBV primarily infects liver cells. Infection may be:
Acute hepatitis B: a newly acquired infection lasting less than six months.
Chronic hepatitis B: infection that persists for six months or longer.
The likelihood of developing chronic infection depends strongly on the age at which infection occurs.
Adults who acquire hepatitis B usually clear the infection naturally.
Babies and young children are much more likely to develop chronic infection if they become infected.
This is one reason preventing mother-to-child transmission and vaccinating babies promptly after birth are so important.
How Common Is Hepatitis B?
Hepatitis B remains a major global public-health problem.
The World Health Organization estimated that about 240 million people were living with chronic hepatitis B infection in 2024, with approximately 900,000 new infections each year.
WHO also estimated that hepatitis B caused around 1.1 million deaths in 2024, mainly from cirrhosis and hepatocellular carcinoma, the most common form of primary liver cancer.
The burden remains particularly high in the WHO African Region.
Acute vs Chronic Hepatitis B
Acute Hepatitis B
Acute hepatitis B refers to infection acquired within the previous six months.
Many people with acute hepatitis B have no symptoms.
When symptoms occur, they may develop several weeks or months after exposure.
Most immunocompetent adults recover completely and develop immunity.
A small proportion can develop severe acute hepatitis or acute liver failure, which requires urgent medical care.
Chronic Hepatitis B
Chronic hepatitis B occurs when infection persists for at least six months.
Some people with chronic infection remain well for many years.
Others gradually develop liver inflammation, fibrosis, cirrhosis or liver cancer.
Chronic infection requires medical evaluation and long-term monitoring even when the person feels healthy.
Not everyone with chronic hepatitis B needs antiviral treatment immediately, but everyone diagnosed with chronic infection should receive appropriate clinical assessment.
What Are the Symptoms of Hepatitis B?
Many people with hepatitis B have no symptoms.
When symptoms occur during acute infection, they can include:
tiredness or fatigue;
loss of appetite;
nausea;
vomiting;
abdominal discomfort, particularly on the right side;
dark urine;
pale or clay-coloured stools;
joint pain;
fever; and
jaundice, which causes yellowing of the skin or eyes.
Symptoms alone cannot reliably diagnose hepatitis B.
Blood testing is necessary.
How Is Hepatitis B Transmitted?
Hepatitis B spreads when infected blood or certain body fluids enter another person's body.
Important routes include:
Mother-to-Child Transmission
HBV can pass from an infected mother to her baby during childbirth.
This is one of the most important routes of transmission in places where hepatitis B is common.
Sexual Transmission
Hepatitis B can spread through sexual contact with an infected person, particularly when condoms are not used.
Needles and Injection Equipment
Sharing needles, syringes or other injecting equipment can transmit hepatitis B.
Unsafe Medical Procedures
Inadequately sterilised medical or dental equipment can transmit infection.
Modern blood-screening and infection-prevention systems substantially reduce these risks when correctly implemented.
Sharp Objects
Sharing items that may have traces of blood, such as razors or certain piercing or tattooing equipment, can create a risk.
Occupational Exposure
Healthcare workers and others can become exposed through needlestick injuries or contact with infected blood.
Can Hepatitis B Spread Through Casual Contact?
Hepatitis B is not normally spread through ordinary social contact such as:
hugging;
shaking hands;
coughing;
sneezing;
sharing food;
sharing eating utensils; or
sitting beside someone.
People living with hepatitis B should not be socially isolated or discriminated against.
Who Is at Increased Risk?
People who may have an increased likelihood of HBV exposure include:
babies born to mothers with hepatitis B;
sexual partners of people with hepatitis B;
people with multiple sexual partners;
men who have sex with men;
people who inject drugs;
people who share needles or injecting equipment;
household contacts of people with chronic hepatitis B in some circumstances;
healthcare workers exposed to blood;
people receiving haemodialysis;
people living with HIV;
people with hepatitis C;
people who undergo tattooing, piercing or medical procedures using inadequately sterilised equipment; and
people living in or travelling to areas where hepatitis B is common.
Testing decisions should not depend solely on whether someone recognises themselves as belonging to a particular risk category.
How Is Hepatitis B Diagnosed?
Hepatitis B is diagnosed using blood tests.
Clinical symptoms alone are not enough.
Several blood markers can help determine whether someone:
currently has hepatitis B;
has an acute infection;
has chronic infection;
recovered from a previous infection;
is immune because of vaccination; or
remains susceptible to infection.
Important Hepatitis B Blood Tests
A commonly used hepatitis B screening panel includes:
HBsAg: hepatitis B surface antigen. Its presence usually indicates current HBV infection.
Anti-HBs: antibody to hepatitis B surface antigen. This can indicate immunity after vaccination or recovery from previous infection.
Total anti-HBc: antibody to hepatitis B core antigen. This usually indicates previous or current natural infection rather than vaccination alone.
CDC recommends a triple-panel test using HBsAg, anti-HBs and total anti-HBc for adult screening.
Additional tests may be needed depending on the results.
How Is Acute Hepatitis B Diagnosed?
Testing for IgM anti-HBc can help identify recent or acute HBV infection.
A healthcare professional interprets the different markers together because no single test result should always be interpreted in isolation.
How Is Chronic Hepatitis B Diagnosed?
Chronic hepatitis B is generally diagnosed when HBsAg remains present for six months or longer or when other laboratory and clinical evidence confirms chronic infection.
People diagnosed with chronic hepatitis B may require additional tests such as:
liver-function tests;
HBV DNA viral load;
HBeAg and anti-HBe testing;
complete blood count;
assessment for liver fibrosis or cirrhosis;
kidney-function testing before or during certain treatments;
hepatitis C testing;
HIV testing;
hepatitis D testing where appropriate; and
liver ultrasound or other imaging when indicated.
A liver biopsy is not routinely required for everyone. Non-invasive approaches are increasingly used to assess liver fibrosis.
Who Should Be Tested?
Testing is important because many people with hepatitis B do not know they are infected.
CDC currently recommends that all adults aged 18 years and older be screened at least once during their lifetime using the triple-panel test.
Pregnant women should also be tested during every pregnancy, preferably early in pregnancy.
People with ongoing risk of exposure may require periodic testing.
Local testing recommendations can differ, so Nigerian readers should also follow current national guidance and advice from qualified healthcare professionals.
Hepatitis B and Pregnancy
Hepatitis B deserves special attention during pregnancy because the virus can pass from mother to child during delivery.
Pregnant women should be screened for hepatitis B.
When a pregnant woman has hepatitis B, further assessment may include HBV DNA viral-load testing.
WHO's updated chronic hepatitis B guidance expands eligibility for antiviral prophylaxis during pregnancy to reduce mother-to-child transmission in appropriate patients.
Babies should receive hepatitis B vaccination as soon as possible after birth.
WHO recommends that all infants receive the hepatitis B birth dose within 24 hours of birth, followed by the remaining recommended vaccine doses.
Is Hepatitis B Treatable?
Yes.
The treatment approach depends on whether the infection is acute or chronic.
Treatment of Acute Hepatitis B
There is no specific antiviral treatment routinely required for uncomplicated acute hepatitis B.
Care generally focuses on:
adequate fluids;
appropriate nutrition;
symptom management; and
monitoring for complications.
People with severe illness may require hospital care.
Treatment of Chronic Hepatitis B
Chronic hepatitis B can be treated with antiviral medicines.
The aim is to suppress viral replication, reduce liver inflammation and lower the risk of cirrhosis, liver failure and liver cancer.
Commonly recommended oral antiviral medicines include:
tenofovir, and
entecavir.
WHO's 2024 hepatitis B guidelines simplified and expanded treatment eligibility so that more people with chronic HBV can benefit from antiviral therapy.
Not every person with chronic hepatitis B needs treatment immediately.
Treatment decisions depend on factors such as:
HBV DNA levels;
liver inflammation;
presence of fibrosis or cirrhosis;
age;
other medical conditions;
pregnancy;
HIV coinfection; and
other clinical findings.
People with chronic hepatitis B should therefore be assessed by a clinician experienced in managing the condition.
Does Treatment Cure Hepatitis B?
Current antiviral medicines can strongly suppress hepatitis B, but they do not usually completely eliminate HBV from the body.
Treatment can nevertheless greatly reduce the risk of serious liver complications.
Many people who start long-term antiviral treatment may need to continue it for many years or lifelong, depending on their circumstances.
Hepatitis B and HIV
HIV and hepatitis B can occur together.
This matters because coinfection can affect liver disease and treatment decisions.
Tenofovir, which is widely used as part of HIV treatment, is also active against hepatitis B.
People with HIV should therefore have appropriate hepatitis B screening and treatment decisions coordinated with their HIV care.
Can Hepatitis B Cause Liver Cancer?
Yes.
Long-term hepatitis B infection can increase the risk of:
chronic liver inflammation;
liver fibrosis;
cirrhosis;
liver failure; and
hepatocellular carcinoma.
Some people with chronic hepatitis B may require regular surveillance for liver cancer using ultrasound and other assessments depending on their age, liver condition, family history and other risk factors.
How Can Hepatitis B Be Prevented?
1. Vaccination
Vaccination is the most effective way to prevent hepatitis B.
WHO describes hepatitis B vaccination as safe and highly effective.
2. Vaccination at Birth
Babies should receive the first hepatitis B vaccine dose as soon as possible after birth, ideally within 24 hours.
This is particularly important for preventing mother-to-child transmission.
3. Safer Sex
Correct condom use can reduce sexual transmission.
4. Do Not Share Needles
Never share needles, syringes or other equipment used for injecting drugs.
5. Use Sterile Equipment
Tattooing, piercing, medical and dental procedures should use properly sterilised equipment.
6. Avoid Sharing Blood-Contaminated Personal Items
Avoid sharing razors, needles and other objects that may become contaminated with blood.
7. Protect Healthcare Workers
Healthcare workers should receive hepatitis B vaccination and follow standard infection-prevention procedures.
Living With Chronic Hepatitis B
People living with chronic hepatitis B can often live long and healthy lives with appropriate care.
Important steps may include:
attending regular medical follow-up;
taking antiviral medication exactly as prescribed when treatment is required;
avoiding excessive alcohol consumption;
discussing medicines, herbal products and supplements with a healthcare professional;
maintaining a healthy weight;
testing for other viral hepatitis infections where appropriate;
screening close contacts when advised; and
ensuring household or sexual contacts are vaccinated if they are not already immune.
Avoid assuming that "natural" or herbal remedies are safe for the liver.
Some herbal preparations and supplements can cause liver injury.
Frequently Asked Questions
Can hepatitis B go away on its own?
Yes, many adults with acute hepatitis B clear the infection naturally.
However, babies and young children are much more likely to develop chronic infection.
Can someone have hepatitis B without symptoms?
Yes.
Many people with hepatitis B feel completely well.
Testing is the only reliable way to know your infection status.
Is hepatitis B an STI?
Hepatitis B can be transmitted sexually, but sexual contact is only one route of transmission.
It can also spread from mother to child, through infected blood and through contaminated needles or sharp instruments.
Can hepatitis B be cured?
Most adults with acute hepatitis B recover without developing chronic infection.
For chronic hepatitis B, current antiviral medicines usually suppress rather than completely eradicate the virus.
Effective treatment can still substantially reduce the risk of serious liver complications.
Can hepatitis B be prevented?
Yes.
Vaccination is highly effective, and additional preventive measures include safer sex, safe injection practices, blood screening and prevention of mother-to-child transmission.
Can I get hepatitis B from sharing food?
Hepatitis B is not ordinarily transmitted through sharing food, hugging, coughing or casual contact.
When Should You See a Healthcare Professional?
Seek medical assessment if you:
think you may have been exposed to hepatitis B;
develop jaundice, dark urine or other symptoms of hepatitis;
are pregnant and have not been screened;
live with someone who has hepatitis B;
have a sexual partner diagnosed with hepatitis B;
have HIV or hepatitis C;
inject drugs;
have abnormal liver tests; or
want to know whether you are protected by vaccination.
Early testing allows people who are infected to receive monitoring and treatment when needed and helps protect others from infection.
The Bottom Line
Hepatitis B is a preventable viral infection that can cause both short-term and chronic liver disease.
Many people have no symptoms, which is why testing is important.
The hepatitis B vaccine provides highly effective protection. Preventing infection at birth is particularly important because babies infected early in life have a much higher risk of developing chronic disease.
For people living with chronic hepatitis B, regular monitoring and antiviral treatment when indicated can substantially reduce the risk of cirrhosis and liver cancer.
If you think you may have been exposed to hepatitis B or are unsure of your vaccination or testing status, speak with a qualified healthcare professional.
References
World Health Organization. Hepatitis B. Updated 28 July 2026.
https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
World Health Organization. Guidelines for the prevention, diagnosis, care and treatment for people with chronic hepatitis B infection. 2024.
https://www.who.int/publications/i/item/9789240090903
Centers for Disease Control and Prevention. Clinical Testing and Diagnosis for Hepatitis B.
https://www.cdc.gov/hepatitis-b/hcp/diagnosis-testing/index.html
Centers for Disease Control and Prevention. Clinical Care of Hepatitis B.
https://www.cdc.gov/hepatitis-b/hcp/clinical-care/index.html
World Health Organization Regional Office for Africa. Hepatitis B and C Fact Sheet 2025.
https://www.afro.who.int/publications/hepatitis-b-and-c-fact-sheet-2025
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