Hepatitis B

Hepatitis B is a liver infection caused by the Hepatitis B Virus (HBV). Infection can be acute (lasting less than 6 months and usually clearing on its own in adults) or chronic (lasting more than 6 months, and potentially lifelong).

India has a 'moderate-to-high' Hepatitis B prevalence of around 3–4% of the population. Chronic HBV is a leading cause of liver cirrhosis and hepatocellular carcinoma (liver cancer) in India. Early detection is critical because effective antiviral treatments can prevent liver damage.

Most adults newly infected with HBV have no symptoms or only mild symptoms. When symptoms do appear (typically 1–4 months after infection), they may include:

• Fatigue and general malaise
• Jaundice — yellowing of the skin and whites of the eyes
• Dark (tea-coloured) urine
• Pale or clay-coloured stools
• Nausea, vomiting, and loss of appetite
• Abdominal pain, especially in the upper right area (over the liver)
• Joint pain

Chronic Hepatitis B often produces no symptoms for years or decades, during which time liver damage accumulates silently. Many people discover they have chronic HBV only through a blood test.

HBV is 50–100 times more infectious than HIV and can survive on surfaces outside the body for up to 7 days.

• Unprotected sexual contact (vaginal, anal, or oral sex)
• Sharing needles, syringes, razors, or toothbrushes contaminated with infected blood
• Mother-to-child transmission at birth — a major route in India
• Blood transfusions or medical procedures with unsterilised equipment
• Unsterilised tattooing or piercing

Hepatitis B is NOT spread through casual contact, sharing food or water, hugging, coughing, or sneezing.

• HBsAg (Hepatitis B surface antigen) — the primary screening test. Positive result = current HBV infection. Window period: 1–9 weeks.
• Anti-HBs (Hepatitis B surface antibody) — indicates recovery from past infection or vaccination-induced immunity.
• Anti-HBc (core antibody) — indicates current or past infection.
• HBV DNA (viral load) — measures the amount of virus in the blood; used to monitor treatment and assess infectivity.
• Liver function tests (LFTs) — assess liver health.

Acute Hepatitis B usually resolves on its own with rest, adequate hydration, and avoidance of alcohol. Hospitalisation may be needed in severe cases.

Chronic Hepatitis B is managed with antiviral medications that suppress viral replication and prevent liver damage:

• Tenofovir disoproxil fumarate (TDF) — first-line treatment in India
• Entecavir — an alternative for patients who cannot tolerate TDF
• Treatment does not cure HBV but controls it effectively
• Available at government hospitals under NVHCP (National Viral Hepatitis Control Programme)

• Before starting a new sexual relationship
• If you were born in India and have never been tested (HBV prevalence is significant)
• Pregnant women — to prevent mother-to-child transmission
• Healthcare workers — annual screening recommended
• If you have ever shared needles or injection equipment
• If you have a sexual partner who has HBV