vs. Chronic HBV
Acute Hepatitis B - Recovery
- Chronic Hepatitis B
Acute Hepatitis B
An acute infection may last up to six months (with or without
symptoms) and infected persons are able to pass the virus to others
during this stage. A patient will test positive for the
hepatitis B virus (HBsAg+), HBc-IgM, and possibly the HBe-antigen.
Safe sex practices and vaccination of close household members should
Symptoms of an acute infection may include loss of appetite, myalgia,
nausea, low-grade fever, and possible right upper quadrant or midepigastric
pain. Although most people do not experience symptoms, they can
appear 45 to 180 days after the virus enters the body. Some people
may experience more severe symptoms that will require immediate medical
A small number of people have symptoms that last for months. They
may have signs of abnormal liver function before they completely
recover from the acute infection. Most infected persons do not require
hospitalization, although some may require close medical attention.
Treatment of acute hepatitis B is generally supportive, which may
or may not require hospitalization. Rest and managing symptoms
are the primary goals of therapy. Additional follow-up blood tests
are needed to diagnose recovery from an acute infection or
the progression to a chronic infection.
In rare cases involving fulminant hepatitis, liver transplantation
may be indicated.
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An estimated 90% of adults with healthy immune systems
will recover successfully from an acute infection and develop positive
surface antibodies that will protect them against
future hepatitis B infections.
Infants and children, however, have a much higher risk of progressing
to a chronic infection when first infected with hepatitis B. Infants
have only a 10% of recovering from an acute infection and young
children have up to a 50% chance of recovering. Therefore, the age
at which one is first infected makes a significant difference in
determining the final outcome.
When blood tests show that a person has lost the virus (HBsAg-)
and develops the protective surface antibody (HBsAb+ or anti-HBs+),
then they have recovered from an acute infection and are no
longer contagious to others. This can take up to six months after
the initial infection.
People who have recovered are still at risk for other types
of hepatitis infections. Therefore,
people who have recovered should get the hepatitis A vaccine and
avoid risk factors for hepatitis C. In addition, this group should
be advised to limit their alcohol, quit smoking, and avoid
liver toxins to avoid future liver disease problems. Follow-up visits
may be recommended.
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Chronic Hepatitis B
If a person tests positive for the hepatitis B virus (HBsAg+)
for more than 6 months, then they are diagnosed as having a chronic
infection. Approximately 10% of infected adults will develop
chronic infections, which increases their risk for cirrhosis, liver
failure or liver cancer.
The risk of developing a chronic hepatitis B infection
is directly related to the age at which one becomes infected with
the virus. 90% of infants infected at birth and up to 50%
of young children infected between the ages of 1 and 5 years will
develop a chronic hepatitis B infection.
Most people with chronic infection have no symptoms, but they
can still spread the virus to others. Therefore, screening and vaccination
of close family or household members and sex partners should be
initiated to prevent further infection.
All patients with chronic hepatitis B infections should be monitored
on a regular basis for disease progression by a liver specialist
("hepatologist") or a doctor knowledgeable about hepatitis B.
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Page last modified October 21, 2009