Hepatitis B: symptoms, contagion, anti-HBS, vaccine, is there a cure?

Hepatitis are diseases that affect the liver and can bring several complications to those who have them. Several of them are caused by viruses and are sexually transmitted.

Viral hepatitis, like hepatitis B, can be very dangerous. Having information on how to protect yourself is very important.


What is hepatitis B?

Hepatitis B is one of the hepatitis, a set of inflammations that affect the liver. They can be caused by a variety of conditions, but type B, specifically, is an infection caused by the Hepatitis B Virus (HBV).

When it affects adults, in milder cases, the disease usually resolves on its own. But in children or some adults, it can become chronic. This means that it is not eliminated from the body by the immune system and causes extensive damage throughout life.

It is transmitted through body fluids and can be contracted through intercourse and needle sharing.

The virus is especially contagious and is easily transmitted.

When transmission occurs, HBV contaminates hepatocytes , liver cells, multiplying within them and then breaking them down, resulting in more viruses in the body. These viruses then resume the reproduction cycle.

The immune system then attacks the viruses, destroying the infected hepatocytes. However, several healthy hepatocytes can also be destroyed.

Within a few weeks, the virus is eliminated from the body, except in cases where the immune system is not strong enough, which results in the development of the disease to the chronic form.

But there are ways to prevent the disease, including the hepatitis B vaccine.

The hepatitis B code at ICD-10  is B16 .


Despite always having a similar action, hepatitis B can be presented in 3 different types. Are they:

Acute hepatitis B

In the classic version, acute hepatitis B occurs when a person contracts HBV in any of the possible types of contagion, either through contact with blood or through sexual intercourse.

In this case, the disease presents itself affecting the hepatocytes, causing the destruction of the cells for the virus to reproduce. The consequence is that this reduces the liver’s ability to act, which has the function of metabolizing substances ingested by the body.

The immune system attacks the virus, eliminating infection and infected, healthy hepatocytes in the process.

Within a few weeks the virus is no longer in the body, the liver recovers from damage and the patient is immune to hepatitis B contamination.

Chronic hepatitis B

Chronic hepatitis B is more common in children, but it can affect adults in up to 25% of cases. Hepatitis is defined as chronic when, after 6 months of infection, the virus is still present in the body.

The mechanism of action of chronic hepatitis B is the same as that of acute, however, in this case, the virus is not completely eliminated and causes inflammation of the liver cells again.

That is, the patient is not able to heal on his own and, as a result of several subsequent inflammations in the organ, the liver is damaged.

This organ involvement can lead to liver cirrhosis , which is a disease characterized by the formation of scar tissue in the liver and which can kill. It can also cause liver cancer .

In the case of chronic hepatitis, a liver transplant may be necessary to rid the patient of a damaged liver, but it is not possible to remove the virus completely and the disease may return.

Fulminant hepatitis B

Fulminant hepatitis is a rare event that arises when the disease develops too quickly, affecting many cells in the body.

The hepatitis B virus is the biggest cause of this type of hepatitis, although in most cases it happens when HBV acts together with hepatitis D. In cases of hepatitis without the hepatitis B virus, the fulminant version is much more rare.

This type of hepatitis can cause death in a short time, as liver functions are severely compromised.

As a consequence, neurological diseases can also occur, such as portosystemic encephalopathy, which occurs when substances that should be metabolized by the liver are not.

In cases of fulminant hepatitis, the worsening of symptoms is rapid and sudden, and hospitalization is necessary.

Causes of hepatitis B

Hepatitis B is caused by the Hepatitis B Virus or HBV . This virus is extremely contagious and affects the liver, as well as all viral hepatitis viruses – hepatitis A, B, C, D and E.

Read more: What is Hepatitis A, transmission, symptoms, vaccine, has a cure?

HBV settles inside the liver cells and uses them to reproduce. The immune system attacks the infected cells, thus causing an inflammatory process, hepatitis.

Read more: Hepatitis C: cure, symptoms, what it is, treatment, contagion and more

What is the form of transmission of hepatitis B?

The hepatitis B virus is present in blood, sperm, vaginal fluids and breast milk. It is a sexually transmitted disease  , which means that unprotected sex can be a means of contagion.

It is also possible to contract hepatitis B by sharing syringes. If one of the people using the syringe is contaminated, the other can become infected.

Hepatitis B is extremely contagious, being 50 to 100 times more transmissible than HIV . However, despite transmissibility, it is not possible to catch hepatitis through the air, saliva or contact .

The main risk factors for contamination by the hepatitis B virus are:

Syringe sharing

Needle sharing is one of the ways in which hepatitis B can be contracted. If an infected person uses a syringe and lends it to another person, transmission can easily occur.

This happens most often in the case of injecting drug use where syringes are divided, but it can also happen in hospitals that do not perform proper hygiene or when someone shares syringes for some medication.

Unprotected sex

Unprotected sex is one of the main transmission factors. The virus can be found in vaginal fluids and sperm, so having sex without a condom (the only contraceptive method that protects against STIs) with someone infected can result in HBV contamination.

Tattoo needle reuse

Tattoo needles must be well sterilized and, like syringes, tattoo needles must not be reused, as blood-borne diseases can be contracted in this way.

If the material is used on someone with hepatitis B and then reused on a person who does not have the disease, there is a chance of contamination.

Symptoms of hepatitis B

Hepatitis B has a long incubation period, which can last from a few weeks to 6 months, and only after that do the symptoms appear.

In milder cases, the immune system can eliminate the virus without any sign appearing. However, in many cases, symptoms arise.

In young children, the disease is also usually asymptomatic, but there is a high possibility that it will become chronic, which can cause cirrhosis after years.

Symptoms, when they arise, are:

Abdominal pain

Hepatitis B affects the liver and causes abdominal pain in the region of the organ. The liver is on the right side of the body, close to the ribs.

Dark urine

The liver is responsible for the metabolism of bilirubin , a yellowish pigment natural to the human body.

Hepatitis B prevents the liver from metabolizing bilirubin properly and so it is the kidney that filters it. Bilirubin leaves the body in the urine, leaving it with a dark yellowish color.


Bilirubin, the yellowish pigment that the liver usually metabolizes and releases through bile, can accumulate in the blood and skin before being filtered by the kidneys in cases where the liver is unable to function properly.

During hepatitis B, bilirubin accumulates in the blood and skin, leaving the person with a yellowish appearance, which indicates that the liver is not working properly.

In addition, the sclera , the whites of the eye, can also turn yellow due to the accumulation of pigment.

Light stools

Normally, the liver metabolizes bilirubin and eliminates it through bile, which goes into the intestine and exits in the stool. Part of the stool color is due to this substance.

When bilirubin is not passing from the liver to bile because of hepatitis B (or any other condition), the stool may be lighter than normal.


Inflammation and infections often cause fever , which is a natural reaction caused by the immune system. It is expected in cases of hepatitis B.

Joint pain

Joint pain is one of the symptoms of hepatitis B. In this case, it is called “Serum-like syndrome”.

Its functioning is like the serum disease , which happens due to the binding of antibodies with certain substances such as drugs or the heterologous serum , which is produced in immunological interactions.

In the case of hepatitis B, it is not a true serum disease, but it is similar, hence the name. It causes joint pain due to deposition of the substance formed by the binding of antibodies to other things.

Loss of appetite

Hepatitis B can cause loss of appetite in patients, a common symptom related to conditions in the gastrointestinal and hepatic systems.


Vomiting can happen in case of hepatitis B. It is important that the patient remains hydrated, as vomiting can cause the body to lose a lot of water, causing dehydration.


The disease causes weakness and it is important that the patient get enough rest to save energy and allow the body to face the infection effectively. Resting is essential during hepatitis B.

How is hepatitis B diagnosed?

The diagnosis of hepatitis B is laboratorial, made through the blood test, and the doctor in charge is the general practitioner or the hepatologist .

In addition to using the blood test, it is possible to raise suspicion with a high degree of reliability through the rapid hepatitis B test , which can be applied in the office.

Rapid test for hepatitis B

The rapid hepatitis B test can be applied in the office and detects HBsAg , which is the antigen produced by the body to fight the hepatitis B virus.

If this antigen is found in the blood, it means that the infection is active.

For the exam, the doctor takes a blood sample from the patient’s finger and analyzes it with the rapid test, which can give an inconclusive, negative or positive result.

If the result is negative, it is confirmed that the patient does not have the virus. However, if the result is inconclusive or positive, it is necessary to perform a blood test for diagnosis, since even in positive cases, there may be a false positive .

Blood test

A blood test is performed to identify HBsAg antigens , which when present indicate that the infection is active and its result is positive. It is more accurate than the rapid test, performed in the laboratory, as well as being able to detect the virus itself in the blood.

In addition, through a blood test it is possible to find other immune cells that can give more details about the patient’s situation.

While HBsAg antigens indicate that the infection is active (acute), anti-HBs indicate that the person is immune, either by vaccination or by having had the disease in the past.

The presence of the Anti-HBs IGM antigen , in turn, indicates a recent infection. If the test is negative for all antigens, it means that this patient has not been in contact with the virus.

After the laboratory examination is completed, the diagnosis can be made official and treatment started.

Anti-HBs: reference values

The anti-HBs test is not measured in reference values, but in positive or negative for certain types of antigen or for the virus itself.

The presence of HBsAg antigens indicates active infection. The presence of anti-HBs antigens indicates immunity and the presence of anti-HBs IGM antigens indicates, in addition to immunity, a recent infection. The presence of the Anti HBc Total antigen indicates that an infection has occurred previously.

In general, values ​​less than 10mUI / mL indicate non-reagent . The patient may not be immunized (vaccinated) or is infected. Concentrations greater than 100mUI / mL mean reagent, or that the person is immune or cured of the disease.

The reference values ​​may change according to the type of exam and the laboratory, so remember that the doctor is the professional trained to analyze and interpret the exam

Hepatitis B has a cure?

-Yeah . Hepatitis B tends to cure itself and, in cases of fulminant hepatitis B, antivirals can be used in the hospital to ensure the patient’s survival.

However, in cases where the disease becomes chronic, treatment becomes more complex since the patient’s own immune system is not able to eliminate viruses.

In such cases, there is no cure. Chronic hepatitis can cause a lot of damage to the organ, so liver transplantation may prove necessary.

What is the treatment of hepatitis B?

The treatment of hepatitis B, in most cases, is simple, but in some people the process can be more complicated. It all depends on the type of hepatitis B.

Remember not to force the liver during treatment for hepatitis B. This means not drinking alcohol at all, as this substance is metabolized in the liver.

If the organ is not functioning properly, you can get intoxicated with alcohol much more easily, as well as further damage the liver.

Monitoring and observation

Acute hepatitis B, in most cases, does not need medical treatment. It is enough for the person to rest well, drink plenty of water and use the medications prescribed to relieve possible symptoms.

The immune system can handle the virus in a few weeks and, in many cases, no symptoms appear or are weak.


Fulminant hepatitis, on the other hand, is more serious due to the speed with which it acts. The patient may need to be hospitalized and medical attention becomes necessary, specifically antivirals, for the rapid elimination of the virus.


Antiviral drugs are used to treat both chronic and fulminant hepatitis.

In the case of chronic, it is not possible to eliminate HBV completely, but it is possible that the medication will be used for a prolonged and continuous way.

However, in cases where hepatitis has not been treated for a long time, permanent damage may be present in the liver and there may be cirrhosis or even liver cancer .

Liver transplant

When liver damage is too extensive, liver transplantation may prove necessary. This does not cure the disease, as the virus may be in the body, but it is a way to ensure that the patient survives and can continue treatment.


The drugs used to treat hepatitis B are antiviral and are especially aimed at those who have chronic or fulminant hepatitis B.

Drug treatment helps prevent further liver damage by eliminating as many viruses as possible in a short time. Some options are:

  • Entecavir (Baraclude);
  • Adefovir (Hepsera);
  • Lamivudina (Epivir);

These drugs can be found in the Unified Health System (SUS).


NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Living with hepatitis B

When you have chronic hepatitis B, care must be taken to prevent more serious complications from appearing, in addition to preventing transmission. Are they:

Avoid alcohol

Alcohol affects the liver and can cause problems if the patient who has hepatitis B ingests it. Liver damage becomes easier, which can develop, over time, to cirrhosis, which can kill.

Warn your doctors

Whenever you go to a doctor’s appointment, notify the doctor that you have hepatitis B. This will make sure that the drugs used are not those that affect the liver, or that these drugs, if necessary, are used with greater care due to the condition.

Use condom

Prevent the disease from spreading to others. Use a condom, reducing the risk of contaminating your partners with hepatitis B.

Hepatitis B and pregnancy

Hepatitis B can be transmitted to the fetus during pregnancy, so it is essential that pregnant women get tested for hepatitis, so that doctors are aware of a possible infection and can protect the baby from the virus.

Can the mother transmit hepatitis B to the baby?

-Yeah . Vertical transmission, that is, from mother to child, can occur both before, during and after childbirth, in addition to being possible through breastfeeding.

The time when the infection tends to occur most often is during childbirth and, before that, it is quite rare. However, it is possible to avoid this contamination.

The first dose of the hepatitis B vaccine immediately after delivery, added to the application of human anti-hepatitis B immunoglobulin in the first 12 hours of the child’s life usually prevents vertical contamination in 90% of cases.

It is essential that this care be taken if the mother has hepatitis B, since between 70% and 90% of cases of vertical transmission evolve to chronic hepatitis.


In most cases, the prognosis of hepatitis B is good and the patient survives without further complications.

However, in cases where the disease is chronic, which happens in 10% to 30% of cases, treatment will be necessary for life, or there is a high risk of kidney damage over time.

In the case of fulminant hepatitis B, there are greater risks that can range from kidney damage to neurological damage and death, so it is important that care is performed as soon as possible.


Hepatitis B, despite curing on its own in many cases, can have unpleasant consequences. Between them:

Chronic hepatitis B

Chronic hepatitis B is one of the main possible complications of hepatitis B. The disease does not leave the body and, over the years, the liver can be greatly affected by the condition. Which leads to the next complication.


Especially in cases of chronic hepatitis, cirrhosis can arise when the liver is severely damaged by the disease. The liver is the organ that regenerates faster, but even it has a limit and can eventually be covered with scar tissue.

When this happens, your function may be impaired.

Cirrhosis is a serious terminal illness that eventually kills the patient. The only possible treatment is a liver transplant.

Liver cancer

Repeated liver damage from chronic hepatitis can lead to liver cancer . This is the most feared complication of the disease and one of the main reasons why prevention is extremely necessary.

Brain damage

When fulminant hepatitis B is present, liver function can be quickly damaged, which can increase the number of toxins in the body, even leading to brain damage.


Death can happen due to liver damage or lack of activity. This usually does not happen with patients who have only the acute version of the disease, but in the chronic and fulminating versions, death is a real danger.

How to prevent hepatitis B?

There are several ways to prevent and not get hepatitis B. They are:


The vaccine is the most effective method to prevent hepatitis B since, even if you are infected in some way, your immune system will be ready to face the virus before it can even settle.

Hepatitis B can be a dangerous disease, but it is easily preventable through the vaccine that can be given from the first day of life.

Use condom

The only contraceptive method that prevents the transmission of sexually transmitted infections (STIs) is the condom, as it prevents direct contact with fluids that can transmit the hepatitis B virus.

Remember to use a condom, especially if you are going to have sex with a new partner.

Do not share syringes

Sharing syringes is one way of transmitting hepatitis B. Always use new syringes and do not share them . In addition to hepatitis, other diseases can be transmitted in this way, such as HIV.

Do not share tattoo needles

Like syringes, tattoo needles come into contact with liquids that may be contaminated, such as blood.

Whenever getting a tattoo, be sure of the hygiene standards of the place and find out about the sterilization of the materials used.

Hepatitis B vaccine

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The hepatitis B vaccine is the main and most effective way to protect yourself from the disease. It is divided into three doses and the first can be given on the first day of life to protect the child from the virus.

Immunization is part of the national vaccination program and is essential to ensure that people are healthy.

Pregnant women are also advised to receive the vaccine, which prevents the mother from contracting the disease and passing it on to the baby.

The vaccine uses inactivated viruses to give the immune system a sample of the virus. The body then starts to produce antibodies to that specific virus and if active versions of it ever appear, the body will be ready to face the infection before it grows.

Read more: Package of the vaccine against recombinant hepatitis B

Common questions

Can I drink alcohol with hepatitis?

No! Alcohol is metabolized in the liver, which is an organ that needs rest to recover during hepatitis. If you drink alcohol, it can damage it even more.

In addition, depending on the state of the liver, alcohol intake can cause intoxication since it is responsible for its metabolism.

Stay away from alcoholic beverages while recovering from hepatitis.

Can I get hepatitis B through the air?

No . The only way to get hepatitis is through the exchange of fluids such as blood, sperm and vaginal fluids, in addition to breast milk. Other fluids, such as saliva, do not transmit the virus. Sneezing and touch also cannot charge the HBV.

How do you get hepatitis B?

It is possible to get hepatitis B through unprotected sex , sharing syringes and tattoo needles and through breastfeeding .

Can women with hepatitis B breastfeed?

Only if the baby is vaccinated . The virus is transmitted through breast milk, but if the baby is vaccinated, he will be immune to hepatitis B and can drink the contaminated milk without any major problems.

I got hepatitis B. Am I immune to hepatitis A and C?

No . The viruses of each hepatitis are different and, therefore, having immunity to one does not mean having immunity to another. Even if you have already caught any of the hepatitis, take precautions to avoid the others, such as using condoms and not sharing syringes.

Hepatitis B is a sexually transmitted disease that can result in cirrhosis, but most of the time it heals on its own.

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