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17. Why is chronic HBV called a silent killer?

So in the Asian Liver Center, we call chronic hepatitis B a silent killer because many people who have chronic infection have no symptoms. They don’t even know they have been infected. Sometimes routine liver function blood tests when you go for your annual physical are normal. So if your doctor doesn’t order a special blood test, they don’t even know you have chronic hepatitis B. So the patient and the doctors have a false sense of security and if you wait until you have symptoms, it is usually very late from advanced liver cancer or liver failure.