Simple Guide To Understanding Chronic Hepatitis B

What is chronic hepatitis B?


Hepatitis B is an infection of the liver caused by a virus spread through blood and body fluids. When a person is first infected with the hepatitis B virus, it is called an acute infection (or a new infection). Most healthy adults that are infected may suffer with jaundice and abdominal pain and vomiting, but usually get rid of the infection within six months and don’t need any follow-up as they become immune to it. However, most infants, around half of young children, and a small percentage of adults are unable to get rid of the virus after six months and are diagnosed as having a ‘chronic infection’. A blood test can diagnose an acute or chronic hepatitis B infection.


With Chronic Hepatitis B the immune system attacks the infected liver cells causing damage, and the liver tries to heal by scarring. Over many years, this scarring becomes worse and eventually leads to cirrhosis where the liver becomes small and hard. If untreated the liver may lose function, leading to bleeding from the gut and liver failure.


Most adults with chronic Hepatitis B were infected at birth or in early childhood. Adults with chronic hepatitis B are infected for life and have long-term risk of developing chronic liver disease, which may progress to cirrhosis, liver failure and liver cancer.

How is hepatitis B transmitted?


Hepatitis B is spread through contact with blood or body fluids. The age of infection is very important in determining whether the person develops a lifelong chronic condition or whether they can clear the infection. More than 90% of babies infected via their mother during birth and up to 50% of young children under five who are infected by contact with other children or by close-contact with an older household member will develop chronic hepatitis B. When young children and infants get infected, they don’t display any immediate symptoms, but they develop chronic infection with the associated life-long risks of cirrhosis, liver failure and liver cancer.


Adults are usually infected by having unprotected sexual contact with someone who has hepatitis B, injecting through drug use or tattooing with unsterilized equipment.


Prevention, treatment & care


Vaccination is very effective at preventing hepatitis B (HBV), and whilst not routinely available on the NHS, it is recommended for several risk groups including:

  • Babies born to mothers with hepatitis B.

  • Susceptible household members and sexual contacts of HBV sufferers.

  • Health care or prison workers who come into contact with blood or body fluids.

  • People who inject drugs or have a partner who injects drugs.

  • People who have multiple sexual partners.

  • Men who have sex with men.

  • People who receive blood transfusions regularly.

  • Anyone with any type of liver disease.

  • Sufferers of chronic kidney disease.

  • Anyone travelling to a high-risk country.

  • Anyone adopting or caring for a child from a high-risk country.

  • Prisoners.

Effective treatments are available to control chronic hepatitis B. All infected children (and adults infected as children) require long-term monitoring and follow-up treatment if there are signs of disease progression.


The good news is that most people with the infection will usually live a long and healthy life if they take care of their liver. Sufferers of chronic HBV are advised to limit or avoid alcohol, keep within a healthy weight range, avoid fatty foods and ensure they have regular blood tests (6 monthly) to monitor their livers.


To find out more about Chronic Hepatitis B visit the British Liver Trust website or download their Hepatitis B information leaflet.

Around 400 million people worldwide are chronically infected with hepatitis B. Although the UK has a lower incidence than many countries, around 1 in every 350 people has the infection. Unfortunately, most of us don’t know what hepatitis B is, or how you get it.