Hep B Blog

Diagnosed With Hepatitis B? Symptoms? Learning the HBV Basics

The tricky part about hepatitis B symptoms is that there are often no symptoms. That is why hepatitis B is referred to as a “silent infection”. This can be a little confusing to people newly diagnosed with HBV – whether it is determined you have an acute or chronic infection.

If you have a new, acute infection, there is a good chance you will be one of the roughly 69% with no notable symptoms. You may feel a little under-the-weather or a little more tired then usual, or you may notice no difference at all. You may learn about your infection through blood work following a possible exposure, or following screening from a blood donation. Since 90% of adults infected with hepatitis B will clear the infection – most with no medical intervention, it is possible for you to be infected, clear the virus, and never even know until blood work shows evidence of a past infection.

Then again you may be one of the roughly 30% who do have symptoms. You may experience flu-like symptoms such as achy muscles and joints, a low-grade fever and fatigue. Because your liver plays a role in digestion, you may experience a loss of appetite, feel a little nauseous, or experience pain in the upper right quadrant of your abdomen. You may have dark, tea colored urine. Then again, these symptoms may not be so severe that you take much notice. It’s okay, because these symptoms typically do not require treatment. However, if you are symptomatic, or you are concerned, please see your doctor, so blood tests can be run to be sure your liver is safe.

Here are the important symptoms that you need to have checked-out immediately: jaundice, severe nausea and vomiting, and bloating or swelling of the abdomen. If you have any of these symptoms, you need to seek immediate medical attention. Your doctor will want to run blood work, which will likely need to be repeated while you are symptomatic and as you recover, to monitor your condition and be sure you are safe. At this time, your doctor will determine the next steps –perhaps you will need to be admitted to the hospital for fluids and observation if you are severely dehydrated, or more likely, you’ll recover at home with regular lab work and follow-up with your doctor.

If you notice that your skin or the whites of your eyes are yellow, then you are suffering from jaundice. This is due to a build-up of bilirubin in the blood and tissues. Your liver is an amazing organ and one of its responsibilities is the filtering out of your body’s bi-products or other toxins from your blood, maintaining them at healthy levels. Jaundice is very unsettling to those that have it because it is noticeable by others. Normal coloring will return once the body is able to rid itself of the buildup of these toxins.

Although rare, (approximately 1%) acute hepatitis B can result in life-threatening, fulminant hepatitis, which can lead to liver failure. Fulminant hepatitis requires immediate medical attention.

The other possibility is that you are actually chronically infected, and that your infection is not new, or acute. You may have been living with HBV since birth or early childhood. Your hepatitis B infection may be a complete surprise to you.  You might ask, “How could I have this infection all of these years and not even know it?” Once again, HBV is a silent infection.  For those chronically infected, obvious symptoms may not occur for decades. The liver is a hard-working, non-complaining organ, but you don’t want to ignore your HBV and put yourself at increased risk for cirrhosis, liver failure or liver cancer. Believe it or not, the sooner you learn about your HBV infection, the better, so that you get regular monitoring, seek treatment if necessary, and make lifestyle changes that are good for your liver and overall health.

Whether you have symptoms or not, there are a few things you need to remember. You must go back to your doctor for further lab work to determine if your HBV infection is acute or chronic. If you are still surface antigen positive (HBsAg+) after 6 months, then you have a chronic infection and need to see a liver specialist to learn more about your hepatitis B infection. The other thing you must do is take precautions so you do not transmit hepatitis B to sexual partners and close household contacts.  Fortunately, HBV is a vaccine preventable disease.  Finally, be sure to take care of your liver by eating a well-balanced diet, avoiding alcohol, and talk to your doctor or pharmacist about prescriptions or OTC drugs that may be hard on your liver.

Comments on this blog are closed. If you have questions about hepatitis B or this blog post, please email info@hepb.org or call 215-489-4900.

44 thoughts on “Diagnosed With Hepatitis B? Symptoms? Learning the HBV Basics”

  1. Hello Hepbtalk,
    Maybe a little off topic, however, My partner was diagnosed with Hepatitis A. As soon as I learned that, I got my vaccination started. The next shot is due after six months. My doctor told me that I have to get BOTH of the shots to get fully immunized. My question is, would kissing my partner after symptoms going away make me infected? From my reading, I noticed that people may need 6 months to recover fully. Does that mean no contact with my partner for 6 months?!

    1. I’m a little confused with your question. Hepatitis A is transmitted very differently and is quite contagious whereas direct contact with infected blood or body fluids is necessary to transmit HBV. It’s true that with any vaccine, you will not be fully protected unless you have gotten the shots in the series according to schedule. There will likely be coverage with each injection, but the amount of coverage varies from person to person based on their immune system, etc. If your partner had/has HAV then you need to take careful precautions while he is infected with HAV. Did you also receive a shot of immunoglobin to protect you against his HAV? It is true that it may take as long as 2 to 6 months to recover from an HAV infection, though I am not sure if he is infectious for that entire amount of time. Please speak with your doctor if you have specific questions so you can avoid contracting HAV from your partner.

  2. i have start having itchy skin and pain around my lower ribcage. I tested positive for the hepatitis B antigen a month ago. Can this mean I am HBV positive?

    1. Not everyone with an acute case of hepatitis B has symptoms, but your symptoms of itching skin and abdominal pain under the rib-cage are classic symptoms. If you are HBsAg positive then you currently have HBV. 90% of healthy adults are able to clear the virus on their own and do not require medication or supportive care. However, I would encourage you to see your doctor to be sure your liver function is good and there are no special concerns. Your doctor will run more blood work – perhaps a few times to see that everything is within safe ranges. During this time, please be sure to avoid alcohol. Drink plenty of good, clean water and eat a well balanced diet with fruits and vegetable, whole grains and lean meats. You should clear your infection within 6 months, otherwise your infection is considered chronic. Please be sure you are tested after 6 months to ensure the virus is gone and you have resolved the infection. Please remember that during this time, you are infectious to others so please take precautions and avoid direct contact with your infected body fluids (blood and sexual fluids) and others. Please be sure sexual partners are screened for HBV 4-6 weeks after exposure.

      1. I was diagnosed with hep b not knowing how serious this is I went 2 years with no treatment now I noticed I get tiered fast my urine was on the dark side I drank a lot of water one day my urine went clear I sometimes wake up with poor circulation that goes away I’m waiting to go back to doctor for the right blood work that needs to be done . Worried sick

        1. Hello: I encourage you to see your doctor and get tested to find out how your hepatitis B infection is affecting your liver and health. If you were infected as an adult, your immune system may have cleared the infection. If you were infected at birth or during early childhood, you may have a long-term or chronic infection.
          Getting tested again will help you understand your hepatitis B status, and also determine if the infection is causing any of the symptoms you have described.
          For more information that may help you, please visit: http://www.hepb.org/prevention-and-diagnosis/newly-diagnosed/
          Good luck.

  3. I recieved the Hep A/B initial immunization I went away to Turkey i became ill but i thought it was food borne illness because after I vomited I felt better. I had oral sex with my boyfriend who was told he had Hepatitis, he does not know which. There was no genital to genital unprotected sex. when I came home I had the secondary injection. i recently completed the third. my doctor will do a blood test in November. do you think I had any immunity to Hepatitis A or B?

    1. The amount of immunity generated after each injection varies with the person and their immune response, but yes you would have had some immunity to HBV and HAV. I suspect that your food borne illness was just that, and not HAV. Most likely your boyfriend has HBV or HCV. The likelihood of transmission would be low with HBV and very unlikely with HCV ( via oral sex). If you have any open sores in the mouth etc. then transmission odds would be higher. It’s a good idea to talk to your boyfriend to determine what he is infected with, and what precautions you may need to take to avoid transmission.

  4. Hi everybody am tired and sick of this itching I tested hepb positive last two weeks and my itching always go back and come before I go for testing I have been having itching for past three weeks and av done liver function test which is normal….does that mean am chronic hepb..and I work as lab technical I want to quit my job now because of this

    1. The itching can be very irritating. This occurs as a result of excess bilirubin in the blood stream and may occur with an acute infection or a flare with a chronic infection, and of course for other reasons. You will need to retest to see if you have a chronic HBV infection. If you test HBsAg+ for more than 6 months then you are considered chronically infected. You can also ask your doctor to run an HBcAb IgM test which when positive suggests a new or acute infection. Regardless, retest HBsAg in 6 months. Don’t quit your job because you have HBV. You can get beyond this!

  5. I was diagnose hepatitise b positive for six years now but i recently feel headach and abdomenal pain please what should i do

    1. The only thing you can do is see a liver specialist to learn more about your HBV and liver health. This is all done through blood work and some sort of imagery such as an ultrasound of the abdomen. The headache doesn’t sound like a direct symptom of HBV, but there are certainly a number of reasons for headache. Be sure you are hydrated. Your abdominal pain could also be as a result of something other than your HBV, but you really what to confirm the reason for your pain.

    1. You have a chronic HBV infection since you continue to be HBsAg positive for greater than 6 months. You need to learn more about your HBV and your liver health. We would recommend that you see a liver specialist and learn more about your HBV and liver health. Regardless of your situation, take care to not transmit HBV to others by avoiding direct contact with blood and body fluids. Sexual partners and close household contacts should be screened to see if they have a current or resolved HBV infection. If they test negative, then they should be vaccinated to protect against HBV. In general,keep open cuts etc covered, practice safe sex or sex with partners that are vaccinated to protect against HBV, and do not share personal items such as razors, toothbrushes or anything that could have even very small amounts of blood on them. Also be sure to take care of your liver health by NOT drinking alcohol. Avoid smoking and environmental toxins. Be sure to maintain a healthy weight by eating a well balanced diet. Once again, we recommend that you see a liver specialist to learn more about your situation.

  6. Hi, I tested HBsAg positive last week, though am on the HB profile test now. But there’s alwaiz been this sound in my stomach for the past one week, also my urine is becoming dark “lipton” colour with headache at intervals. Dos it mean am HBV positive and what stage is it?. What do I do??

    1. Hello: If you were screened for the first time, you probably don’t know if this is a new infection, or if you have been infected since childhood. In six months, your doctor should screen you again and at that time he or she can determine if you had an acute (short-term) infection, or whether it is a chronic infection (which means you were probably infected during childhood.) Dark urine can be an indication of active hepatitis B. I encourage you to contact your doctor and share these symptoms, especially if they worsen. Good luck.

  7. hi, I was diagnosed with acute hbv 3 months ago. I was placed on tenofovir immediately after the test. a month later I learnt that no drug is needed for acute hbv because it would clear after 6 months. what should I do? would the antiviral drug affect my chances of clearing the virus?

    1. Hello: Usually people are not treated with antivirals when they have a new hepatitis B infection (acute) unless there is serious liver damage occurring, which would be indicated by liver enzyme tests (called ALT or SGPT). Did the doctor find signs of liver damage? Was this the first time you ever tested positive for hepatitis B? Usually when healthy adults are infected with hepatitis B, they are able to clear the infection in a few weeks or months and usually don’t need treatment. Antivirals in general make it hard for the virus to reproduce and lowers the amount of virus in your body, taking the antiviral during acute hepatitis B will lower the ability of the virus to replicate during the “clearance” phase and may even be helpful. You should talk to your doctor so you understand why you were put on antivirals. Good luck.

    1. Hello: It is hard to tell if that is the result of your hepatitis B infection. I encourage you to see your doctor and explain your medical condition. Good luck.

  8. Hi there I had hep b vac because I’m a health care worker my serum is 16.9 but I was positive for hbsag what does this mean

    1. Hello: If you test positive for the hepatitis B surface antigen (HBsAg) it means you are currently infected with hepatitis B. What exactly did you test 16.9 for? Was that hepatitis B surface antibodies? I recommend you contact your doctor and review the test results with him/her, and perhaps get tested again to clarify the results. Good luck.

      1. Hey, i was tested negative for hepatitis b some 7 months ago. After which i took the first shot for the vaccine. I didnt take any other shot afterwards. After feeling so much pains on my right chest and left chest. I decided to do some other tests for hepatitis b and c to be sure i have no problem. I was tested positive hbsag antigene.Right now i dont know what to do. Ive lossed weight and i still feel pains on my right chest . What do i do plzz

        1. Hello: Usually pains in your chest are not associated with hepatitis B. Please see your doctor immediately and describe your symptoms to see if they result from another medical condition.
          If you have tested negative for the hepatitis B surface antigen (HBsAg) in the past, and now test positive for it, you may have been infected recently, perhaps shortly before your vaccine dose. You must be tested again in six months for HBsAg to determine if you have an acute or short-term infection, which will clear over a six-month period, or whether you were infected during early childhood and now have a chronic infection.
          Also, ask your doctor to test your liver enzymes (called ALT or SGPT) to see if the infection is causing any liver damage. Good luck.

  9. If you have vacinnated against hepatitis b four years ago, right before vaccination, you tested non reactive before vaccination.
    Can you still catch the virus, in other words, how effcetive is the vaccination.

    I deep kissed someone and two days after i bloated for three days. Are these symptoms of hepatitis b?

    1. Hello: The immunization is very effective, as long as you received all three doses. Kissing does not spread hepatitis B. The bloating you experienced is not normally associated with hepatitis B. If it continues, please consult with your doctor, it may result from an unrelated medical condition. Good luck.

  10. I was tested positive for hep b 5 weeks ago my urune was dark yellow also my eyes now they are back to nirnal color again but u still have itching under my feet what does this means

    1. Hello: As you have read, a small number of people experience physical symptoms when they are newly infected with hepatitis B. Please talk to your doctor about your itchy feet, to make sure it is not resulting from another medical condition. Also, please get tested again six months after this test to find our if you were able to clear hepatitis B. Good luck.

  11. Hello I went for my hepatitis B viral profile test report

    Comment:Chronic HBV infection with a non replicating virus

    Pls what does this information mean

      1. Hello: There is no cure yet for hepatitis B, however if you should ever experience liver damage and require treatment, there are two very effective antivirals–tenofovir (Viread) and entecavir–that quickly reduce your viral load (HBV DNA) and your risk of liver damage. Remember that most people with hepatitis B live long and healthy lives, especially if they avoid alcohol and cigarettes. Live a healthy lifestyle, get monitored and you can live a full life.
        To find out the latest in hepatitis B drug development, please visit our Drug Watch page at: http://www.hepb.org/treatment-and-management/drug-watch/
        Good luck.

    1. Hello: When we are infected with the hepatitis B virus, we test positive or reactive for the hepatitis B surface antigen (HBsAg).
      As our immune systems start to fight the infection, they produce antibodies to eradicate or get rid of the hepatitis B antigens. It’s a good sign to test negative for the hepatitis B “e” antigen (HBeAg) and positive for the hepatitis B “e” antibody (HBeAb). It can mean your viral load is low.
      Is this the first time you have been tested for hepatitis B? To know if you were recently infected and have a short-term “acute” infection, you need to be tested again in six months.
      When healthy adults are infected, it takes about six months for their immune systems to get rid of the infection. The last hepatitis B “antigen” to disappear is the surface antigen (HBsAg). Having a low number of HBsAg is good.
      When newborns or children are infected, their immature immune systems don’t recognize and fight the infection and it can become chronic and last for many years.
      Keep in mind that not everyone with hepatitis B requires treatment, many people live long and healthy lives with hepatitis B. Generally, medical guidelines recommend treatment if you are experiencing liver damage. This is indicated by an ultrasound and a simple blood test for the liver enzyme ALT (also called SGPT). Our liver cells release ALT when they are damaged or die. Healthy ALT levels for men are up to 30, and for women they are up to 19. Please consult with your doctor and see what your ALT levels are to determine if you require treatment. Good luck.

  12. I was diagnosed of hepB and it was positive since last two years and i have been all the doctor asked me to do except from regular checkup. But i am really having a lot of noisy stomach, i am just wondering if its a sign of chronic hepB.

    1. Hello: Stomach disorders as you describe are not usually associated with chronic hepatitis B. For more information about abdominal pain and hepatitis B, please read: https://www.hepb.org/blog/when-is-that-pain-hep-b-related-and-when-is-it-something-else/
      Please continue to see your doctor regularly, be sure to describe your symptoms, and make sure your liver enzymes (ALT or SGPT) are tested regularly to make sure your hepatitis B infection is not affecting your liver. Good luck.

  13. Hello, the last time I had an unprotected sex is about 6 months ago, and that exposed my to uti which I treated with injection and some antibiotics on doctor’s prescription. I ran and HIV test which came out negative. I didn’t do an HBV test, but recently I had a reoccurent mild headache, and this morning I noticed a dull pain below my right rib cage which went away after some minutes, thus is the first time I will pay attention to this, could have been happening without me noticing. My urine is clear and no obvious signs of jaundice. I’m a right to suspect hepatitis B??

    1. Hello: Those are not usual symptoms for hepatitis B, but you should get tested for hepatitis B and VACCINATED so you never again have to worry about becoming infected. Good luck.

  14. I have been tested and confirm of been hepatitis B positive thou after a thoroughly test,the Dr said i should go and leave a health life, but right now am have pain at the left side of my rib which latter move down to the upper right of my stomach. Is there any chance that am having a damage liver already,thou i feel ok on the other areas of my body.thanks

  15. Thanks so much,i have done the abdominal test and it show no liver problem,and the pain is no longer there except few pain at my back

    1. Hello: Excellent news, please continue to take good care of your health and get monitored regularly. Good luck.

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