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Viral Hepatitis B

Viral hepatitis refers to infections caused by viruses that affect the liver. Viral hepatitis includes five distinct diseases, caused by five different viruses. The different viruses are called by a letter name:

Hepatitis B Symptoms

Hepatitis B may develop without any signs or symptoms, or symptoms may be nonspecific and short-lived.

There are three phases of hepatitis B, and symptoms may differ depending on the stage.
Early in the disease, called the prodromal phase , symptoms may include:

  • Fever

  • Joint pain or arthritis

  • Rash

  • Edema (swelling)

Symptoms of the next phase, the preicteric phase , include:

  • Fatigue

  • Myalgia (muscle pain)

  • Anorexia

  • Nausea and/or vomiting

  • Fever

  • Cough

  • Abdominal pain and/or diarrhea

  • Dark urine and light stool color

During the icteric phase :

  • Jaundice (yellowing of the skin and whites of the eyes) develops

  • Other symptoms may subside

  • Anorexia, nausea and vomiting may worsen

  • Irritated skin lesions may develop

Hepatitis B Diagnosis at Johns Hopkins

There are two types of hepatitis B infections:

  • Acute infection. When a person is first infected with hepatitis B, it is called an acute infection. Symptoms range from no symptoms to liver failure. Usually, adults recover from this and have no further problems.

  • Chronic infection. If the virus remains in the blood for more than six months, then it is considered a chronic infection. While most adults do not develop chronic hepatitis B, infants and young children are less able to rid their bodies of the virus and may develop chronic hepatitis B as a result.

We will begin the diagnosis by conducting a thorough physical examination during which you describe your symptoms and medical history. Other procedures used to diagnose hepatitis B:

Diagnostic Tests

A blood test will be ordered to look for abnormal levels of certain enzymes in your blood. It is also common for a patient with hepatitis B to have a low white blood cell count.

If the blood tests show the presence of HBsAg in your blood for longer than six months, that is a sign of chronic hepatitis B. Chronic infection leads to serious conditions such as cirrhosis, liver failure and hepatocellular carcinoma (liver cancer).

Liver Biopsy

Usually a liver biopsy is not necessary. However, it may be necessary if:

  • Other tests were inconclusive

  • Your symptoms were atypical

  • Your doctor found evidence of chronic liver disease

  • You have complications, such as fluid retention or encephalopathy (confusion)

During a liver biopsy, liver tissue is removed and sent to a pathology lab for analysis to determine if you have hepatitis B.

Hepatitis B Treatment at Johns Hopkins

Acute hepatitis B usually resolves on its own without intervention. Treatment for chronic hepatitis B includes medications to suppress the virus and reduce the risk of long-term medical complications. Learn more about treating hepatitis B at Johns Hopkins.

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