Hepatitis B Overview

Hepatitis B is a liver infection caused by a DNA type virus that is transmitted through contaminated blood or blood derivatives during transfusions, through sexual intercourse with an infected person, or through the use of contaminated needles or other similar instruments. Unlike hepatitis A, the Hepatitis B virus can cause both the acute form of hepatitis, as well as a chronic one. Hepatitis B is the most common chronic disease in the world.

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Short History

Although hepatitis has been known for centuries, no one knew the exact cause until the ’40s, when doctors began to suspect that responsible for the liver disease was a virus transmitted through the human blood. The first step in Hepatitis B virus discovery was made in 1963 when Dr. Baruch Blumberg and his colleagues identified a protein (“the Australia antigen”) that had an unusual reaction to the antibodies of patients who had undergone blood transfusion. The association between the antigen and liver infection was made only three years later, and health care specialists understood that in order to reduce the risk of infection with Hepatitis B the blood should be tested before the transfusion. The Hepatitis B virus has been demonstrated to be 100 times more infectious than the AIDS virus, however it can be halted with a vaccine that is safe and effective. Although, for the over 400 million people worldwide who are already infected with the chronic form of with Hepatitis B, the vaccine is of no more use. Any child with chlamydiosis requires a consultation done by a senior medical specialist to determine the exact cause of the ailment, and also to investigate a possible sexual abuse.

Hepatitis B in the United States of America

  • 12 million Americans are known to be infected (1 out of 20 people).
  • Over one million people are already infected chronically.
  • Over 100,000 new people will become infected with each year.
  • 5,000 people will die every year due to the Hepatitis B virus and the complications it produces.
  • Approximately 1 health care worker dies each day from Hepatitis B.

Hepatitis B Symptoms

Incubation Period

The Hepatitis B virus has an incubation period between 45 and 160 days (on average about 100 days). Symptoms usually occur in the first 30 to 180 days after coming into contact with the Hepatitis B virus, but it must be noted that half of those infected with the virus will not show any signs of infection at all. Acute Hepatitis B bolsters an onset of symptoms, but things are different when it comes to the chronic manifestation of the infection, which most often is asymptomatic. People suffering from acute Hepatitis B symptoms may experience “flu”-like symptoms marked by nausea, anorexia, malaise and physical fatigue, pain near the liver and jaundice. Symptoms of acute hepatitis last on average between 1-3 months. During this time, the infected person is highly contagious. The virus is very resistant in normal environments, although it is considered that hot water used in the washing machine is normally able to kill the virus on clothing, and also dishwashing detergent and warm water will remove the ones from the pans. In the acute phase, Hepatitis B produces symptoms ranging in severity from a single, mostly asymptomatic event to fatal events. Statistics suggest that more than one third of those infected with the virus show no symptoms, this infection they believed to be “quiet” form of the disease. Another third of those infected with the Hepatitis B virus show symptoms similar to those caused by the flu: physical weakness, fever, pain, headaches, loss of appetite, diarrhea, jaundice, nausea and vomiting. A third of those infected will present more severe symptoms that manifest themselves over longer periods of time. In addition to symptoms similar to those caused by influenza, other symptoms can occur, such as: severe abdominal pain and a more severe form of jaundice. Jaundice occurs as a consequence of the fact that the liver is unable to remove bilirubin (a pigment in parameters higher than normal, causing yellowing of the skin and eyes) in the blood.

Hepatitis B Treatment

If the infected person goes to the doctor immediately after coming into contact with the virus, he will receive a Hepatitis B vaccine in a dose to stimulate the immune system to fight off the infection. In patients with acute Hepatitis B, bed rest is recommended to speedup healing. Some doctors recommend a special diet and advise patients to eat as much as they can, despite the nausea. The consumption of alcohol is prohibited whilst taking acetaminophen (Tylenol), because it can adversely affect the liver. Before taking any other medicines, herbal remedies or vitamin supplements, consult your doctor as some may aggravate the liver damage. If the acute hepatitis does not cure and persists for more than six months, and is still active (which is called chronic active Hepatitis B), your doctor may recommend a more aggressive course of treatment. If the chronic hepatitis is inactive, careful monitoring is recommended without adjuvant therapy. For a patient with symptoms of acute Hepatitis B, drug therapy is not required. In case of coming into contact with HBV, a Hepatitis B immunoglobulin injection within 24 hours helps protect against and infection with Hepatitis B. At the same time other three Hepatitis B vaccines should be administered. Doctors also recommend a proper diet (more consistent in the morning), hydration, avoiding alcohol and drugs and sexual protection. If the patient has evolved from acute hepatitis to chronic hepatitis, there are unfortunately only a few therapeutic options. The only option for severe liver lesion is liver transplantation. It is recommend browsing or using the following drugs: interferon (interferon body intake should be loaded), lamivudine and dipivixil adefovir (both help prevent the intracellular replication of the virus). Hepatitis B vaccination is the most effective method against infection with the hepatitis virus. The vaccine has been available since 1982 and prevent infections with Hepatitis B and other associated infections. People who get vaccinated are protected against acute forms of Hepatitis B, as well as more serious consequences that can lead to chronic form: cirrhosis or liver cancer. Hepatitis B vaccine produces effective levels of antibodies against Hepatitis B virus in most people, children and newborns. There are very few cases of severe allergy to a component of the vaccine. Recent studies indicate that immunologic memory remains intact for a period of at least 25 years and confers protection against Hepatitis B illness even if the number of antibodies falls below detectable quantities.

Hepatitis B Testing

Most children infected with Hepatitis B develop the chronic form of Hepatitis B. The risk of chronicity depends on the age at which they are infected. More than 90% of infected infants, 50% of children and 5% of adults infected with Hepatitis B will develop chronic hepatitis. The chronic form of Hepatitis B consists of 4 phases:

  • The immune tolerance phase (replicative phase) – characterized by normal transaminase (SGPT and SGOT), HBs antigen positive and a high viral load. In people infected during childhood, this phase can last between 15 and 30 years.
  • The immune clearance phase (immunoreactivity, chronic hepatitis) – the most common, can last for years. It is characterized by elevated transaminases, HBeAg-positive and high viral replication.
  • The low viral replication stage (inactive carrier of HBV) is characterized by the presence of HBsAg, HBeAg in absence, or very low undetectable viremia and normal transaminases.
  • The reactivation phase is characterized by elevated transaminases, viral replication and an HBeAg possible recurrence. This phase can be spontaneous or may be due to mutations or due to a viral coinfection.

Laboratory Tests

  • Transaminase levels are very high;
  • HBsAg positive;
  • Very high viremia (1000000000-1000000000 virions / ml)


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