Hepatitis B: Causes, Symptoms, & Treatment

What is Hepatitis B?

Hepatitis B is a serious viral infection caused by the HBV virus. The virus spreads through contact with bodily fluids such as blood, semen, or saliva. The infection causes severe liver inflammation, which can lead to permanent liver damage if not managed promptly. While the infection resolves on its own in most cases, chronic hepatitis B can slowly and silently damage the liver for years and increase the possibility of liver cirrhosis and liver cancer. The virus can remain in the human body for years, sometimes without noticeable symptoms, and the person can continue to spread the condition to others.

Timely diagnosis and proper treatment play an important role in preventing the severe long-term effects of this infection. An effective vaccine is available for protection, and treatment options can make the virus inactive.

What are the Types of Hepatitis B?

Hepatitis B is divided into two types based on how long it lasts and its nature:

How Common is Hepatitis B in India?

India has a substantial number of people with hepatitis B, with approximately 40 million people infected with the virus. According to the Global Hepatitis Report 2026 released by the WHO, India is one of the 10 countries where 69% of global deaths due to hepatitis B take place. It is one of the countries that have the highest burden of hepatitis B cases in the world. Around 6,00,000 deaths in the Indian subcontinent are caused by this condition.

In India, HBV infections cause around 30% of liver cirrhosis cases and up to 50% of liver cancer cases. Despite these high numbers, only 34% of the at-risk population is covered by the government's vaccination programme. With these alarming numbers, we can conclude that hepatitis B is a serious concern in India.

What are the Symptoms of Hepatitis B?

One of the most challenging aspects of diagnosing hepatitis B is that many people with the infection show very few or no symptoms at all for the first few years. When symptoms start showing, they can range from mild to severe.

The signs include:

• Jaundice- a condition where the skin and white area in the eyes turn yellowish.

• Darker urine

• Clay-coloured stools

• Feeling weak and tired

• Nausea or vomiting

• Abdominal pain or discomfort, particularly in the upper right side

• Fever

• Swollen arms, legs, or belly due to fluid retention

• Not feeling hungry

• Joint pain and muscle aches.

In acute hepatitis B, symptoms typically appear within 1 to 4 months after infection and last for many weeks. In chronic cases, the disease progresses slowly, and symptoms only start showing when significant liver damage has already occurred.

What Causes Hepatitis B?

Hepatitis B is caused by the HBV (Hepatitis B virus), a part of the Hepadnaviridae family. The virus is transmitted through contact with infected blood or some body fluids. It can be transmitted through one of the following ways:

• Transmission from Mother: An infected mother can pass the virus to her newborn during childbirth. This is the most common mode of transmission in India.

• Sexual Intercourse: Having unprotected sexual intercourse with an infected partner can be a cause of disease transfer.

• Needles and Syringes: Using the same syringe and needle as the infected person can lead to hepatitis B. For example, a healthcare worker can be at a high risk of transmission due to accidental injury from a syringe used on an infected patient.

• Blood Transfusions or Organ Transplants: Receiving unchecked blood or organs remains a potential cause of transfer. However, the advancements in technology have greatly reduced this risk.

• Sharing Personal Items: Sharing razors, toothbrushes, or nail cutters with an infected person can lead to transmission due to their possible contact with bodily fluids.

Risk Factors of Hepatitis B

Although hepatitis B can affect anyone, certain factors can make a person more likely to contract the infection. These include:

• Being Born to an Infected Mother: Babies born to someone with hepatitis B have a higher chance of acquiring the infection during childbirth if proper preventive measures are not taken.

• Living in or Originating from High-Prevalence Regions: People born in countries where hepatitis B is widespread are at a higher risk of having the disease. Individuals whose parents belong to regions where the disease is common may also face a greater risk if not vaccinated.

• Living with an Infected Person: Household members of someone with chronic hepatitis B may be at higher risk due to ongoing exposure to contaminated personal items or body fluids.

• Working in High-Exposure Occupations: Healthcare workers, emergency responders, and other professionals who may come into contact with blood as part of their job have an increased risk of infection.

• Existing Infections or Liver Conditions: People with hepatitis C, HIV, sexually transmitted infections, or other liver-related diseases may be more vulnerable to hepatitis B.

• Kidney Disease Requiring Dialysis: Individuals undergoing regular dialysis treatment have a higher risk due to repeated exposure to medical procedures involving blood.

• Weakened Immune System: People taking immunosuppressive medicines, including certain cancer treatments, may be more susceptible to infection.

What are the Complications of Hepatitis B?

When hepatitis B becomes chronic, it can cause a number of serious and life-threatening complications:

• Liver Cirrhosis: In this condition, the liver gets severely scarred and cannot function normally due to the scar tissue. This scarring is caused by inflammation due to hepatitis B.

• Liver Failure: Severe scarring on the liver can result in liver failure, where the liver can no longer perform its functions. This is a life-threatening condition that may require a liver transplant.

• Liver Cancer: Chronic hepatitis B can cause hepatocellular carcinoma, a serious type of liver cancer. The infection changes in liver cells, leading them to produce more diseased cells and form a tumour

• Reactivation: In patients receiving immunosuppressive therapies (such as chemotherapy), a suppressed HBV infection can reactivate and cause severe acute hepatitis.

• Kidney Issues: HBV can deposit immune complexes in the kidneys, causing inflammation and impaired kidney function.

• Vasculitis: Inflammation of blood vessels (polyarteritis nodosa) can occur due to complications of chronic HBV infection.

When Should I See My Healthcare Provider?

You should visit a doctor right away if you develop symptoms that are commonly seen in hepatitis B. This can include jaundice, dark urine, persistent fatigue, or stomach pain. If you have factors that increase the risk of hepatitis B, such as a close family member or spouse/partner diagnosed with the virus, or if you are an unvaccinated healthcare worker, you should get checked even if your symptoms are mild.

If you have already been diagnosed with chronic hepatitis B, regular check-ups with a gastroenterologist or hepatologist are important to monitor liver health and change treatment if required.

How is Hepatitis B Diagnosed?

Hepatitis B is diagnosed through various blood tests and, in some cases, imaging studies and liver biopsy. Here's an overview of the process:

How is Hepatitis B Treated?

The treatment for Hepatitis B depends on whether the infection is acute or chronic, the level of viral activity, and the extent of liver damage.

Can Hepatitis B be Prevented?

Yes, it is possible to prevent hepatitis B with proper vaccination. The hepatitis B vaccine offers close to 100% protection from the disease. It is usually given to newborns, along with booster shots in the few weeks after birth. In India, it is included in the Universal Immunisation Programme and is ideally given right after birth. Adults can also get vaccinated with 2 to 3 doses given over a period of 6 months. If a person is already exposed to HBV, use of Hepatitis B Immunoglobulin (HBIG) and the first dose of the vaccine within 24 hours can prevent infection.

What is the Prognosis of Hepatitis B?

The prognosis of hepatitis B depends on many factors, including the age at infection, the phase of infection (acute or chronic), the presence of co-infections, and the effectiveness of treatment.

The outlook is generally favourable for acute hepatitis B infection. Over 95% of healthy adults diagnosed with hepatitis B recover completely and develop lifelong immunity.

The prognosis of chronic hepatitis B is highly variable. With modern antiviral therapy, patients can slow down or stop the progression of liver disease significantly. Those who are infected can have almost normal lives if they get treated early and respond well to medication.

Does Health Insurance Cover Hepatitis B?

Yes, most health insurance plans in India do cover hepatitis B. It is either covered under the standard health insurance plans or under the critical illness plans. Standard plans cover hospitalisation costs, medical tests like liver function tests, cost of medicines, surgery expenses, and ambulance charges. Under critical illness plans, you get a lump-sum compensation on the basis of the diagnosis, which can be used to pay for the treatment of the disease, including liver transplant and liver cancer treatment. Note that a waiting period of around 90 days and a survival period of 15 to 30 days may be applicable.

As the coverage, waiting periods, exclusions, etc. vary with every insurer, it is important to go through all policy documents carefully to understand the scope.

How Much Health Insurance is Required for Hepatitis B?

Chronic hepatitis B requires long-term treatment, including hospitalisation or surgical intervention in serious cases, which can result in substantial costs. For standard health insurance, a cover of ₹10 to 20 lakh is generally recommended to comfortably manage hospitalisation and related expenses. The higher the cover, the more comprehensive the protection for long-term treatment.