Hepatitis B is a virus that infects the liver. The World Health Organization estimates that about 254 million people were living with chronic hepatitis B in 2022, and it causes more than a million deaths a year, mainly from cirrhosis and liver cancer. Most people with it do not know.
One injection in the first 24 hours of life can protect a baby from a virus that causes liver cancer decades later. That is the power of knowing about hepatitis B.
How it spreads
- From mother to baby at birth, the most common route in many countries
- Blood, including shared needles, unsterile medical or dental equipment, razors and tattoo equipment
- Unprotected sex
- It is not spread by hugging, sharing food or water, coughing or breastfeeding
Symptoms
Many people have no symptoms. Some develop acute illness weeks after infection, with tiredness, nausea, abdominal pain, dark urine and yellow skin or eyes (jaundice). Babies and young children who are infected are much more likely to develop lifelong chronic infection.
Who should be tested?
- All pregnant women
- People born in countries where hepatitis B is common
- Partners and household members of someone with hepatitis B
- People living with HIV or hepatitis C
- People who inject drugs
- Health workers
- Anyone with abnormal liver tests
The main test is a blood test for hepatitis B surface antigen (HBsAg).
The vaccine: protection for life
The hepatitis B vaccine is safe and highly effective. WHO recommends that every baby receives a dose within 24 hours of birth, followed by further doses in infancy. Adults who were not vaccinated, including health workers, should get a full course.
For pregnant women with hepatitis B: the birth dose, sometimes with immunoglobulin and antiviral treatment in late pregnancy, can prevent the baby from being infected.
Treatment
There is no cure yet, but antiviral medicines such as tenofovir and entecavir can control the virus and greatly reduce the risk of liver damage and cancer. Not everyone needs treatment, but everyone with chronic hepatitis B needs regular monitoring.
“But I feel healthy, so I can’t have hepatitis B.”
Most people with chronic hepatitis B feel completely well for years. A simple blood test is the only way to know.
Your next step: check that every child in your family has had the hepatitis B vaccine, and ask for a test if you have never had one.
Related: Fatty liver disease · Needlestick injury: what to do
Source: World Health Organization, hepatitis B fact sheet and Global hepatitis report 2024.
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