Hepatitis B is a condition causing inflammation of the liver. It can be a self-limiting issue that resolves independently (acute Hepatitis B), or it may worsen and progress into cirrhosis of the liver (chronic Hepatitis B). If left unchecked, in some instances it can even develop into cancer.
The hepatitis B virus is the most widespread type across the world. It is primarily transmitted through blood and certain bodily fluids, including semen and vaginal fluids. The risk is higher in people who have condomless sex with an infected partner, share injecting equipment, or are exposed to infected blood.
In the UK, it has been estimated that around 180,000 people are living with a chronic infection, wherein they have had an active infection for six months or more. Chronic hepatitis B is defined by persistence of hepatitis B surface antigen (HBsAg) for six months or longer.
While it is not necessarily an endemic disease in the UK, Hepatitis B remains an important global health problem, although the number of cases diagnosed each year varies.
Initial symptoms of hepatitis B infection may not be obvious, or mistaken for the flu. In individual cases where a medical history gives reason to suspect hepatitis B infection, a blood sample will be taken and screened for the presence of antigens to the virus. If the sample is to confirm an active infection , the person will be started on appropriate treatment accordingly.
Quick Overview
Symptoms
Many have no symptoms. If present, they include yellowing skin or eyes, dark urine, extreme tiredness, nausea, and upper stomach pain.
Causes
Hepatitis B is caused by a virus transmitted through infected blood, semen, or vaginal fluids, often during unprotected sex or sharing needles.
Diagnosis
Diagnosis involves a blood test. Our Specialists check for Hepatitis B antigens and antibodies, offering rapid results in thirty minutes or detailed laboratory analysis.
Treatment
Treatment depends on the cause, such as antivirals for herpes or antibiotics for syphilis. Our Specialists provide tailored plans following an examination and testing.
Prevention
Vaccination is the most effective prevention. In some cases, hepatitis B immunoglobulin (HBIG) if given promptly. Using condoms and avoiding sharing needles also reduces risk. Our Specialists offer the vaccine and further confidential advice.
Prognosis
Most adults recover fully. If infection persists, our Specialists provide ongoing monitoring and, where indicated, antiviral treatment.
FAQs
Someone infected with Hepatitis B may not necessarily present with any symptoms. Alternatively, they may experience incredibly mild symptoms, which often will be neglected. Often, individuals who fall sick would present with symptoms similar to the flu and may not necessarily get tested for Hepatitis B.
The most common symptoms of a Hepatitis B infection are as follow:
• Fever
• Extreme fatigue and myalgia (general body pain/aches)
• Joint pain
• Abdominal pain/tenderness
• Loss of appetite
• Nausea/vomiting
• Irregular, pale-coloured bowel movements
• Headache
• Hives
• Yellow coloured skin and/or eyes due to jaundice
Most adults recover completely. A small proportion develop chronic hepatitis B, which can lead to progressive liver disease if not monitored or treated.
Someone infected with Hepatitis B may not necessarily present with any symptoms. Alternatively, they may experience incredibly mild symptoms, which often will be neglected. Often, individuals who fall sick would present with symptoms similar to the flu and may not necessarily get tested for Hepatitis B.
Chronic Hepatitis
Most people infected with Hepatitis B will recover without any issues; however, around 5% of adults who acquire hepatitis B develop chronic infection.
Carriers may pass on the infection to others, which is why they should have routine follow-ups with their doctor and be educated on proper management and care; for example - regular screenings to check their viral titres to monitor the presence of antibodies to the virus.
These individuals are also at a higher risk of developing certain conditions like liver cirrhosis or liver cancer.
Keep in mind that medications are available to help treat Hepatitis B infections.
If Hepatitis B is left untreated for a long period of time, it can lead to chronic liver failure and cirrhosis (scarring) of the liver, which may impair the liver's ability to function adequately and also potentially lead to liver cancer. This highlights the importance of people in high risk groups practicing safe sex with new/casual partners, considering vaccination and also taking part in routine screening.
Most sick individuals will show symptoms anywhere between 6 weeks to 6 months of being exposed to and contracting the virus. Symptoms typically last for a few weeks but, in some instances, may last for months at a time.
Hepatitis B is caused by the hepatitis B virus (HBV), which is spread through contact with infected blood and certain body fluids.
Common ways the virus is transmitted include:
• Sex with someone who has Hepatitis B without effective protection (e.g. vaccination or condoms)
• Sharing needles or other injecting equipment
• Using unsterilised equipment for tattoos, piercings, or medical procedures
• Sharing personal items that may have traces of blood, such as razors or toothbrushes
• From an infected mother to her baby during childbirth
Hepatitis B is not spread through casual contact such as hugging, kissing, sharing food, or sharing cutlery.
If you think you may have been exposed, a simple blood test can check for infection.
You are more likely to get Hepatitis B if you come into contact with infected blood or certain body fluids.
Risk factors include:
• Having sex without a condom, particularly with multiple partners or a partner who has Hepatitis B
• Sharing needles or equipment used to inject drugs
• Having tattoos, piercings, or medical procedures with unsterilised equipment
• Sharing razors, toothbrushes, or other items that may contain traces of blood
• Occupational exposure to blood, such as in healthcare settings
• Being born to a mother with Hepatitis B
• Living in or travelling to countries where Hepatitis B is more common
Vaccination is the most effective way to reduce your risk of infection.
The most effective way to prevent Hepatitis B is by getting vaccinated.
You can also reduce your risk by:
• Using condoms during sex
• Avoiding sharing needles or injecting equipment
• Not sharing razors, toothbrushes, or other items that may have traces of blood
• Choosing reputable providers for tattoos, piercings, and medical procedures that use sterile equipment
If you think you have been exposed to Hepatitis B, seek medical advice as soon as possible. Post-exposure treatment may help prevent infection if given promptly. People at increased risk of hepatitis B should be offered vaccination.
Yes. Condoms greatly reduce the risk of Hepatitis B but do not provide complete protection.
The virus is spread through infected blood and certain body fluids. Transmission can still occur if a condom breaks or slips, or if infected blood comes into contact with skin or mucous membranes not covered by the condom.
Vaccination provides the most reliable protection against Hepatitis B.
The risk of catching Hepatitis B through kissing is extremely low.
The virus is mainly spread through infected blood and certain body fluids, most commonly during unprotected sex, by sharing needles, or from mother to baby during childbirth.
There is a very small theoretical risk if both people have open sores or bleeding gums and blood is exchanged during deep kissing, but this is not considered a common route of transmission.
Yes. Hepatitis B can be spread by sharing personal items that may have traces of infected blood on them.
Items that should not be shared include:
• Razors
• Toothbrushes
• Nail clippers
• Equipment used for tattoos or piercings that has not been properly sterilised
The virus can survive outside the body for up to seven days, so avoiding shared items that may be contaminated with blood is important. Vaccination remains the best protection against Hepatitis B.
Yes, but in the UK the risk is extremely low.
All donated blood is routinely screened for Hepatitis B and other infections before it is used, making transmission through blood transfusions very rare.
If you received a blood transfusion in a country with less stringent screening, or before routine blood donor screening was introduced, you may wish to have a blood test if you are concerned.
Hepatitis B is diagnosed with a blood test that looks for the virus and your body's immune response to it.
Depending on the results, further blood tests may be used to determine whether the infection is recent, long-term, or whether you are immune due to vaccination or a past infection. The timing of testing is also important, as the virus may not be detectable immediately after exposure.
Several blood tests are used to diagnose Hepatitis B and assess the infection.
These may include:
• Hepatitis B surface antigen (HBsAg) to detect a current infection
• Hepatitis B core antibody (anti-HBc) to show whether you have been infected before
• Hepatitis B surface antibody (anti-HBs) to determine immunity from vaccination or past infection
• Hepatitis B DNA (viral load) test to measure the amount of virus in the blood, if an infection is confirmed
• Hepatitis B e-antigen (HBeAg) to help assess how active and infectious the virus is
• Liver function tests (LFTs) are routinely performed alongside hepatitis B serology when assessing a newly diagnosed patient, although they do not diagnose hepatitis B itself.
Your healthcare provider will recommend the most appropriate tests based on your medical history and possible exposure.
An accurate diagnosis depends on your symptoms, medical history, possible exposure, and blood test results.
Your healthcare provider may ask about:
• Recent sexual contact or exposure to blood
• Sharing needles or injecting equipment
• Travel or medical procedures in countries where Hepatitis B is more common
• Your Hepatitis B vaccination history
The timing of testing is also important. Testing too soon after exposure may not detect the virus, so repeat testing may sometimes be recommended.
Yes. Several conditions can cause symptoms similar to Hepatitis B.
These include other forms of viral hepatitis, glandular fever, alcohol-related liver disease, medication-related liver inflammation, and gallstones. Symptoms such as jaundice, fatigue, and dark urine are not specific to Hepatitis B.
A blood test is the only reliable way to confirm whether Hepatitis B is the cause.
Hepatitis B is diagnosed using blood tests. Additional investigations may be used to assess the health of the liver.
If an infection is confirmed, additional tests may be used to assess liver health. These can include liver function tests, a liver ultrasound, FibroScan, or a Hepatitis B DNA test to measure viral load. A liver biopsy is only needed in selected cases.
No. A physical examination alone cannot diagnose Hepatitis B.
Although signs such as jaundice or abdominal tenderness may suggest liver disease, many people with Hepatitis B have no symptoms. A blood test is required to confirm the infection and determine its stage.
No. You cannot diagnose Hepatitis B based on symptoms alone.
Home blood testing kits are available, but the results must be analysed by a laboratory. Because Hepatitis B test results can be complex, they should be interpreted by a healthcare professional to determine whether you have a current infection, a past infection, or immunity from vaccination.
The long-term outlook depends on whether the infection is acute (short-term) or chronic (long-term).
Most adults with acute Hepatitis B recover completely within a few months and develop lifelong immunity. If the infection lasts longer than six months, it is considered chronic. Although chronic Hepatitis B can increase the risk of cirrhosis and liver cancer over time, regular monitoring and, where needed, antiviral treatment can help prevent complications. Many people with chronic Hepatitis B live long, healthy lives.
It depends on the type of infection you had.
If you recovered naturally from an acute Hepatitis B infection, you will usually develop lifelong immunity and cannot catch it again. If you have chronic Hepatitis B, current treatments suppress the virus but do not eradicate it.
Immunity to Hepatitis B does not protect you against other types of viral hepatitis, such as Hepatitis A or Hepatitis C.
If you recovered from an acute Hepatitis B infection, it will not usually return because you develop lifelong immunity.
If you have chronic Hepatitis B, the virus remains in your body but can often be kept under control. To reduce the risk of liver damage:
• Attend regular medical check-ups
• Take antiviral medication if prescribed
• Avoid excessive alcohol
• Maintain a healthy weight and balanced diet
• Tell healthcare providers about your Hepatitis B status before starting treatments that may weaken your immune system
Regular monitoring helps detect any changes early.
It is strongly recommended that you tell your current or recent sexual partners if you have a current or recent Hepatitis B infection.
This allows them to arrange testing and receive the Hepatitis B vaccine if needed. If you have cleared a past infection and are no longer infectious, the risk of transmission is usually gone, but your healthcare provider can confirm your status based on your test results.
Yes. There are several ways to reduce the risk of passing Hepatitis B to others.
These include:
• Encouraging sexual partners and household contacts to get vaccinated
• Using condoms during sex
• Not sharing needles or injecting equipment
• Avoiding sharing personal items that may have traces of blood, such as razors, toothbrushes, or nail clippers
• Following any treatment and attending regular follow-up appointments if you have chronic Hepatitis B
If someone has been exposed to infected blood or body fluids, they should seek medical advice promptly, as post-exposure treatment may help prevent infection.
Yes. Hepatitis B can be passed from a mother to her baby, most commonly during childbirth.
In the UK, all pregnant women are offered routine screening for Hepatitis B. If the infection is detected, the baby will usually receive the first dose of the Hepatitis B vaccine within 24 hours of birth. Some babies may also receive hepatitis B immunoglobulin (HBIG) for additional protection. These measures are highly effective at preventing transmission.
The main concern is passing the virus to the baby during childbirth.
Without preventive treatment, babies infected at birth have a high risk of developing chronic Hepatitis B, which can lead to liver disease later in life. Hepatitis B does not usually cause birth defects, although it may be associated with a slightly increased risk of preterm birth or low birth weight.
Routine screening during pregnancy and prompt treatment for the baby greatly reduce the risk of transmission.
Hepatitis B during pregnancy is relatively uncommon in the UK.
Because many people have no symptoms, all pregnant women are routinely offered screening as part of antenatal care. Early diagnosis allows appropriate treatment and newborn vaccination, which are highly effective at preventing transmission to the baby.
Yes. If you have a high level of Hepatitis B virus in your blood, antiviral treatment may be recommended during pregnancy.
Tenofovir is the antiviral medicine most commonly used and is considered safe during pregnancy. It is usually started during the third trimester to reduce the risk of passing the virus to the baby.
After birth, the baby should receive the Hepatitis B vaccine within 24 hours, and some babies will also receive hepatitis B immunoglobulin (HBIG) for additional protection.
Yes. Routine screening during pregnancy is the most important first step.
If you have Hepatitis B, your healthcare team may recommend:
• Monitoring your viral load during pregnancy
• Antiviral treatment if your viral load is high
• Ensuring your baby receives the Hepatitis B vaccine within 24 hours of birth
• Giving the baby hepatitis B immunoglobulin (HBIG) if recommended
• Completing the baby's full vaccination schedule
Household members and sexual partners should also consider testing and vaccination if they are not already protected.
Hepatitis B does not usually affect recovery after childbirth.
Breastfeeding is considered safe provided your baby has received the recommended Hepatitis B vaccination at birth. Hepatitis B is not spread through breast milk.
Your healthcare provider may recommend follow-up blood tests after delivery to monitor your liver health, especially if you have chronic Hepatitis B or received antiviral treatment during pregnancy.
Page last reviewed by Mrs. Magdalena Nowacka on 06 August 2026 for general guidance only. It is not intended to replace the advice of your clinician.