Symptoms of Hepatitis B

Hepatitis B (also: liver inflammation type B) is a viral infection of the liver. It is usually transmitted via sexual contacts. The disease can be both acute and chronic. Possible symptoms include fatigue, jaundice or discoloration of urine and stool. Sometimes infected people show no symptoms at all. Read more about contagion, symptoms, therapy, prognosis and prevention of hepatitis B!

Symptoms of Hepatitis B

Hepatitis B is usually not so easy to recognize for those affected. Many signs of infection are nonspecific (such as tiredness, nausea). Often there are no symptoms at all (asymptomatic infection). This is particularly treacherous because the highly contagious hepatitis B virus can then be unknowingly transmitted to many healthy people.

Note: About one third of all infected adults show no symptoms. In another third, symptoms such as:

  • Fatigue
  • Lack of appetite
  • Nausea
  • Muscle and joint pain, but no jaundice.
  • Finally, jaundice is present in the last third (in addition to the other complaints).

Incubation period of hepatitis B

The time between infection and onset of the first symptoms of hepatitis B (incubation period) is 30 to 180 days. On average, 60 to 120 days (two to four months) pass until the disease breaks out.

Acute Hepatitis B: Symptoms

Acute hepatitis B begins with nonspecific symptoms such as:

  • loss of appetite
  • aversion to certain foods
  • nausea and vomiting
  • muscle and joint pain
  • mild fever

After about three to ten days – but not necessarily – jaundice (jaundice) may occur: The skin, mucous membranes and the whites of the eyes (sclera) turn yellowish. This is often observed in infants and people with weak immune systems. In addition, the stool may discolor and the urine become dark.

Chronic hepatitis B: symptoms

Hepatitis B is considered to be chronic if specific antibodies to the pathogen are detectable in the blood for more than six months. Symptoms do not necessarily occur in those affected. If yes, then they show up in the form of:

  • fatigue
  • joint and muscle pain
  • anorexia
  • weight loss
  • occasional pressure sensations under the right costal arch

In about one percent of patients, chronic inflammation causes liver cancer or shrinking liver (liver cirrhosis). The risk of liver cancer is even around 100 times higher in hepatitis B patients than in the “normal population”! The development of liver cirrhosis is favored by alcohol abuse and an additional hepatitis C infection.

Additional infection with hepatitis D

Hepatitis B patients may also become infected with hepatitis D. In this so-called superinfection, liver disease is more severe than with hepatitis B infection alone. In addition, the additional type D virus infection further increases the risk of cirrhosis. Liver cancer is also favored: in a combined infection with hepatitis B and D, the malignant tumor forms earlier than in a B infection alone.

Hepatitis B: transmission

Very often, hepatitis B viruses are transmitted via sexual contact – via semen, vaginal secretions or saliva. But other body fluids such as breast milk, tears or blood can transmit the pathogens. So the disease is often passed on infected blood. Therefore, people who handle blood and needles or other sharp objects are particularly at risk for hepatitis B infection.

This includes:

  • medical staff
  • dialysis patients
  • drug addicts
  • Patients receiving blood or plasma (blood products are strictly controlled before administration)
  • People who pierce their ears, tattoos or piercings under unhygienic conditions

Attention: Contagion is also possible through shared toothbrushes and from the mother to her child (during pregnancy or childbirth as well as during breastfeeding). If a mother is known to have a hepatitis B infection, the child will be vaccinated within 12 hours after birth.

Hepatitis B: treatment

In acute infections, no specific hepatitis B therapy is usually necessary – the disease almost always spontaneously heals spontaneously. If necessary, however, the doctor can treat the symptoms.
In addition, patients should take bed rest, take good care of themselves, and eat high carbs but low in fat. Very important is also the renunciation of alcohol – whose detoxification would burden the diseased liver additionally. For the same reason, if possible, no liver-damaging medication such as painkillers and female sex hormones (pill) should be taken.

Chronic hepatitis B is usually treated with antiviral drugs. These include: Nucleoside and nucleotide analogues: They inhibit the proliferation of hepatitis viruses. Are used e.g. Lamivudine, entecavir, telbivudine or tenovovir dipivoxil. The active ingredients are taken as a tablet.

Interferon-α and pegylated interferon α (PEG-interferon α): They are also antiviral and also stimulate the immune system. Their application takes place as an injection.

The goal of drug therapy is to lower the amount of virus in the blood as much as possible. This reduces the risk of liver cirrhosis and liver cancer as a result of chronic hepatitis B. However, the disease with the drugs is usually not curable.

Note: In some patients with chronic hepatitis B, the viruses multiply only slightly, the liver values ​​are often normal and the liver is (still) little damaged. Then the therapy is often limited to regular check-ups.

Protection hepatitis B

The safest protection against hepatitis B is vaccination. It is usually given together with the vaccine against hepatitis A. The vaccine is recommended for:

  • Men who have sex with men
  • People at higher risk during sex (changing partners)
  • People with chronic liver disease
  • People in contact with hepatitis B sufferers (eg hospital staff)
  • People who inject or drug their drug
  • The vaccine is also possible for HIV-positive and recommended.
  • Condoms can reduce but not rule out the risk of hepatitis B.

When it comes to drug use, it’s best to protect yourself by using only your own syringes and accessories.

About the author – Dr. H.S. Hermanides
Dr. H.S. Hermanides obtained a PhD for her research on HIV in the Caribbean. She is currently working as a specialist in infectious diseases at the Red Cross Hospital in Beverwijk, The Netherlands.