Hepatitis B Symptoms

Quick Glance: Common Hepatitis B Symptoms

The early symptoms of hepatitis B can resemble those of other common illnesses. When symptoms occur, they may include the following:

• Feeling unusually tired

• Loss of appetite

• Nausea or vomiting

• Abdominal pain or discomfort

• Fever

• Joint pain

• Dark urine or pale, clay-coloured stools

• Yellowing of the skin or eyes (jaundice)

Many people with hepatitis B do not develop noticeable symptoms, especially young children and people with chronic infection. Symptoms are more commonly seen in people aged 5 years and older who develop acute hepatitis B.

Hepatitis B Symptoms That Should Not Be Ignored

Some symptoms of hepatitis B may indicate significant liver inflammation or complications of advanced liver disease. The table below explains which hepatitis B symptoms need medical assessment and what they may indicate:

These symptoms can have causes other than hepatitis B. Therefore, medical assessment and appropriate testing are needed to determine the cause.

Why Do Hepatitis B Symptoms Occur?

Hepatitis B symptoms develop when the hepatitis B virus (HBV) infects liver cells, and the body's immune system responds to the infection. This immune response can cause inflammation in the liver, which may lead to tiredness, poor appetite, nausea and discomfort in the upper right side of the abdomen.

The liver also processes bilirubin, a yellow substance formed when old red blood cells are broken down. When liver inflammation affects bilirubin processing or bile flow, bilirubin can build up in the blood and cause jaundice. Increased bilirubin in the urine can also make it appear darker, while reduced bile pigments reaching the intestine can make stools appear pale.

Chronic hepatitis B can remain active for years and may gradually cause liver scarring, known as liver cirrhosis. As liver damage progresses, normal liver functions can become impaired and lead to complications such as fluid accumulation, bleeding or changes in mental alertness.

Hepatitis B Symptoms That Require Immediate Medical Attention

Most people with hepatitis B do not develop a medical emergency. However, severe acute hepatitis B or complications of advanced chronic liver disease can sometimes cause serious problems that require urgent medical attention.

Seek emergency medical care if you develop:

• New confusion or unusual behaviour

• Extreme drowsiness or difficulty staying awake

• Loss of consciousness

• Vomiting blood

• Black, tar-like stools

• Severe or uncontrolled bleeding

• Rapidly increasing abdominal swelling

• Collapse or rapidly worsening weakness

These symptoms can occur with severe liver dysfunction, acute liver failure, gastrointestinal bleeding or hepatic encephalopathy. Severe acute hepatitis B can rarely progress to acute liver failure, which can be life-threatening.

Symptoms of Hepatitis B Based on Type

Hepatitis B can be acute, meaning the initial short-term infection, or chronic, meaning the infection remains in the body for a long time. The table below explains how symptoms can differ between acute and chronic hepatitis B:

Most people with chronic hepatitis B are asymptomatic. Acute hepatitis B is more likely to cause noticeable symptoms, particularly in adults and older children.

Symptoms of Hepatitis B in Children

Age can affect how hepatitis B presents. Infants and children younger than 5 years are less likely to develop noticeable symptoms. Children aged 5 years and older are more likely to develop symptoms similar to those seen in adults.

When hepatitis B symptoms occur in children, they may include:

• Tiredness

• Loss of appetite

• Fever

• Nausea or vomiting

• Abdominal pain or discomfort

• Joint pain

• Dark urine or pale stools

• Jaundice

Can You Have Hepatitis B Without Symptoms?

Yes. Many people with hepatitis B have no noticeable symptoms. Chronic hepatitis B can remain silent for years or even decades before symptoms or complications develop.

However, the absence of jaundice, fever or abdominal discomfort does not rule out hepatitis B. Blood tests are used to identify current, previous or recent HBV infection and assess whether further evaluation is needed.

When Can Hepatitis B Symptoms Become Life-Threatening?

Hepatitis B can become life-threatening when severe acute inflammation or advanced chronic liver disease causes the liver to lose important functions. The table below explains the major complications that can make hepatitis B dangerous:

How are Hepatitis B Symptoms Diagnosed?

Symptoms alone cannot diagnose hepatitis B, as many infected people have no symptoms, and other conditions can cause similar signs. Blood tests are used to identify current, previous or recent HBV infection and to assess liver health. The table below explains the main tests used when evaluating possible hepatitis B infection: