Hepatitis B: A-to-Z Guide from Diagnosis to Treatment to Prevention

Hepatitis B virus (HBV) is a virus that attacks the liver, causing serious disease. It is one of many viruses that can cause hepatitis.

The hepatitis B vaccine is the first one that babies get – for good reason. The most likely time for children to catch hepatitis B is around the time of birth. More than two million adults in the United States have chronic hepatitis B infections. About 1/3 of them were first infected as children.

What is it?

Hepatitis B virus (HBV) is a virus that attacks the liver, causing serious disease. It is one of many viruses that can cause hepatitis.

Who gets it?

Anyone can getit. Babies who get it are most likely to get it from their infected mothers. School-aged children are most likely to get it from activities that involve blood contact. Teens are at the highest risk from drug use or sexual contact.

What are the symptoms?

The symptoms vary greatly. Most young children have no symptoms at all (until much later – see below). Some have only a mild illness with loss of appetite, nausea, and fatigue. Some have rashes and arthritis. Others have classic hepatitis with jaundice accompanying the other symptoms.

A few children have full-blown, fulminant fatal hepatitis.

Is it contagious?

Yes, it is transmitted through blood or body fluids. Hepatitis B is sometimes found in the breast milk of infected mothers, but even so, nursing does not appear to increase the risk of transmitting the infection.

How long does it last?

Those who develop symptoms usually do so about 6 weeks after becoming infected. In acute hepatitis B, the symptoms usually last for a month or two.

Many children remain chronically infected. About ¼ of these children eventually die from complications of liver disease caused by the hepatitis B (cancer or cirrhosis). The complications may not arise for 25 or 30 years after the initial infection, and can occur even if the initial infection was mild or caused no symptoms at all.

How is it diagnosed?

Hepatitis B in children is diagnosed by blood tests. Pregnant women are also tested for hepatitis B to help identify which children need to receive special preventive measures.

How is it treated?

Children with hepatitis B should be followed by a specialist. Medicines may be used to try to treat chronic infections. Long-term monitoring is important to watch for early signs of complications. Some children with severe illness are treated with liver transplants. Antibiotics are not useful in treating hepatitis B.

How can it be prevented?

The hepatitis B vaccine is a standard part of the vaccine schedule for young children. Those who missed this series of immunizations can still receive the vaccine for long-term protection.

Babies born to mothers who are infected with hepatitis B should receive hepatitis B immune globulin (HBIG) as soon as possible after birth. HBIG is also important to receive quickly after other known exposures.

Antiviral therapy towards the end of pregnancy and continuing for 4-12 weeks after birth may further decrease the risk of hepatitis B infection from being passed down from mom to baby.

Avoiding exposure to blood and body fluids decreases the risk of exposure to hepatitis B.


Last medical review on: January 04, 2014
About the Author
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Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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