Hepatitis B is a serious infectious liver disease caused by the hepatitis B virus (HBV). It is one of the five main types of hepatitis (A, B, C, D, and E) and is particularly important due to its ability to cause chronic infection and related complications, including liver cirrhosis, liver failure, and hepatocellular carcinoma (liver cancer). A characteristic of hepatitis B is that it can manifest both in acute and chronic forms, and the course and consequences of the infection vary greatly from person to person.

Ways of transmitting hepatitis B

Hepatitis B is an infectious viral disease caused by the hepatitis B virus (HBV), which affects the liver. This virus is transmitted through infected body fluids, and there are various ways of spreading the infection. Understanding these transmission methods is essential to effectively prevent the spread of the disease.

Blood transmission

One of the main ways of transmitting hepatitis B is through infected blood. This includes blood transfusions using non-sterile needles or syringes (especially among intravenous drug users), as well as dental treatment, tattooing, or ear piercing procedures where proper sterility is not maintained.

Unsafe sexual relations

Hepatitis B can also be transmitted through unsafe sexual relations with an infected partner. The virus is present in semen, vaginal secretions, and other body fluids, so any sexual contact with an infected person can cause infection.

Perinatal (vertical) transmission

The hepatitis B virus can be transmitted from an infected mother to her baby during childbirth. This most often occurs through the birth canal but can also happen during pregnancy. To reduce this transmission risk, proper care of pregnant women infected with the hepatitis B virus is necessary.

Close physical contact

Although less common, the hepatitis B virus can also be transmitted through everyday family life if there is close physical contact with an infected person, for example, using shared personal items (toothbrushes, razors) that may have traces of infected blood.

Medical procedures

Infection can be transmitted through non-sterilized medical instruments, such as surgical tools or dental equipment, if they are not properly sterilized after use with an infected patient.

Blood products

Although modern blood transfusion procedures include strict blood donor screenings and blood testing, hepatitis B virus was transmitted through blood products in the past.

While hepatitis B is highly contagious and can be transmitted in various ways, it is important to emphasize that it is not transmitted in everyday social situations, such as hugging, handshaking, through food or water, or using shared dishes or toilets. It is also important to focus on preventive measures, such as vaccination, safe sexual relations, and proper use of personal items, to reduce the risk of hepatitis B infection.

Risk factors for hepatitis B

The risk factors for hepatitis B are varied and related to circumstances and behaviors that increase the likelihood of contracting the hepatitis B virus (HBV). Understanding these factors is important as they help identify individuals and groups who need more prevention and possibly a different approach to healthcare.

  • Unsafe sexual relations: One of the main ways of transmitting hepatitis B is through sexual contact. Individuals who have multiple sexual partners or engage in unsafe sexual practices are at higher risk.
  • Intravenous drug use: Sharing needles and syringes during drug use is one of the risk factors. Even sharing sterile needles can be risky, as the virus can remain on the surface of the needle.
  • Transmitted from mother to child: Vertical transmission of the virus from an infected mother to her baby during childbirth is a significant source of infection. This is particularly relevant for women with active hepatitis B infection or those with a high viral load in their blood.
  • Blood transfusions and organ transplants: Individuals receiving blood products or organ transplants may be vulnerable, especially if the procedures are performed in regions where the hepatitis B virus is highly prevalent and where there is no effective blood donor screening.
  • Non-sterile medical equipment: Infection can be transmitted using non-sterilized medical equipment, including dental instruments, surgical tools, as well as ear piercing, tattooing, or acupuncture procedures.
  • Professional exposure: Healthcare workers working with blood and body fluids are in a higher risk group due to potential contact with infected blood or body fluids.
  • Living or traveling to endemic areas: Individuals living or traveling to regions where hepatitis B is highly prevalent (e.g., Southeast Asia, Africa, certain areas designated by the World Health Organization) have a higher risk of infection.
  • Family member or close contact with an infected person: Living or closely interacting with a person with hepatitis B can also increase the risk of infection, especially through shared personal items, such as toothbrushes or razors.
  • Immune system problems: Individuals with a weakened immune system, including those infected with HIV, suffering from other liver diseases, or taking immunosuppressants, are more vulnerable to hepatitis B virus infection.

Understanding these risk factors is important for taking effective preventive measures, such as vaccination, safe sexual practices, proper sterilization of medical equipment, and information dissemination in risk groups. Vaccination is one of the most effective means of preventing hepatitis B infection, so it is recommended in many countries as part of the national vaccination program.


What are the symptoms of hepatitis B?

The symptoms of hepatitis B vary and can range from mild to severe. Hepatitis B, caused by the hepatitis B virus (HBV), is an infectious liver disease. It can be both acute and chronic, and the severity and manifestation of symptoms depend on the nature of the infection, the age of the individuals, and their overall health condition.

Acute hepatitis B

In the acute stage of infection, which can last several weeks to several months, symptoms can be similar to the flu. These include:

  • Fatigue: Often, there is significant fatigue and general weakness.
  • Fever: Although not present in all patients, it can be an early sign of infection.
  • Abdominal pain: Especially on the right side under the ribs, where the liver is located.
  • Loss of appetite: A common symptom, accompanied by nausea and vomiting.
  • Dark urine and light stools: This can indicate liver function impairment.
  • Jaundice: The skin and whites of the eyes may turn yellow, due to the accumulation of bilirubin in the body when the liver cannot perform its functions properly.

Chronic hepatitis B

In the chronic stage of infection, which can last years or even decades, symptoms can be subtle or completely absent. Some people experience:

  • Chronic fatigue: A constant feeling of fatigue and lack of energy.
  • Nonspecific pains: There may be pains in the abdominal area or other nonspecific pains.
  • Symptoms of chronic liver diseases: Such as skin itching or signs of liver cirrhosis.

Advanced chronic infection

In more severe cases, when the disease progresses, more serious signs of liver damage may appear, including:

  • Ascites: Fluid accumulation in the abdominal cavity.
  • Liver failure: Impaired liver function, which can disrupt circulation and organ function.
  • Liver cancer (hepatocellular carcinoma): Although not common, it is one of the most serious complications of hepatitis B.

It is important to note that many individuals, especially children, can be infected with hepatitis B and have no symptoms. However, even without obvious symptoms, infected individuals can be carriers of the virus and spread the infection to others. Therefore, it is crucial to undergo regular health check-ups, especially if a person is in a risk group, and to get vaccinated against hepatitis B to reduce the risk of spreading the infection.

Possible complications of hepatitis B

Hepatitis B is a serious infectious liver disease that can lead to a variety of complications, especially if it becomes chronic. These complications can significantly affect a patient's health, quality of life, and longevity. The severity of complications depends on various factors, including the activity of the virus, the condition of the liver, and the individual patient's response to the infection.

Liver cirrhosis

One of the most common and serious complications of chronic hepatitis B is liver cirrhosis. Cirrhosis means long-term liver damage, where healthy liver tissues are replaced by scar tissues (fibrosis). This reduces the liver's ability to perform its functions, such as removing toxins from the blood, regulating metabolism, and synthesizing proteins.

Portal hypertension

Cirrhosis can cause increased pressure in the liver veins, known as portal hypertension. This can lead to serious complications, including bleeding from liver vein varices and ascites (fluid accumulation in the abdominal cavity).

Hepatocellular carcinoma (liver cancer)

Chronic hepatitis B significantly increases the risk of hepatocellular carcinoma, one of the forms of liver cancer. It is one of the leading causes of death among patients with chronic hepatitis B.

Liver failure

In severe cases, chronic hepatitis B can progress to fulminant liver failure, a rapidly progressing condition that causes liver function impairment and potentially death.

Extrahepatic complications

Hepatitis B can also cause problems beyond the liver, including immune system disorders, such as vasculitis, and rheumatoid symptoms.

Infection transmission

Individuals with hepatitis B are a source of infection for others, especially if they do not follow precautions to prevent the spread of the virus.

It is important to note that not all individuals with hepatitis B will experience these complications, and the risk can be reduced with proper treatment and regular healthcare. Early diagnosis, regular liver function and condition checks, appropriate treatment, and maintaining a healthy lifestyle are crucial factors that can help manage the disease and prevent its progression into more serious complications. It is also important to avoid alcohol and other substances harmful to the liver to reduce additional strain on the liver.

Tips to help protect against hepatitis B virus

Prevention of hepatitis B is a crucial public health area, as hepatitis B is one of the most infectious and dangerous liver diseases. The hepatitis B virus (HBV) can cause both acute and chronic infections, and chronic infection may progress to liver cirrhosis or even liver cancer.

Preventative measures are multifaceted and include actions at both the individual and public health levels.

  1. Vaccination: This is the most effective measure in the fight against hepatitis B. In many countries, the hepatitis B vaccine is included in national vaccination programs and is usually administered to newborns and children. Adults who have not been previously vaccinated and belong to risk groups should also be vaccinated.
  2. Safe sexual practices: Unsafe sexual practices are one of the main ways of transmitting hepatitis B. The use of condoms and other contraceptive methods can reduce the risk of infection.
  3. Sterile medical equipment: Proper use of disposable needles and syringes in medical institutions is required, as well as sterilization and proper cleaning of all medical instruments.
  4. Personal hygiene products: Never share personal hygiene items, such as toothbrushes, razors, manicure tools, that may be contaminated with blood.
  5. Safe blood transfusion and organ transplantation: Ensure that all blood products and transplanted organs are tested for the hepatitis B virus.
  6. Maternal and newborn health care: Women who are pregnant should be tested for hepatitis B. If the mother is infected, it is important to take measures to prevent the transmission of the virus to the newborn, including newborn vaccination and, if necessary, antiviral treatment.
  7. Education and information: It is important to inform the public about hepatitis B transmission methods, symptoms, and prevention strategies. This includes health education in schools, workplaces, and through public health campaigns.
  8. Regular health check-ups: Individuals who belong to higher risk groups, such as healthcare workers, should regularly be tested for hepatitis B.
  9. Lifestyle changes: Avoiding alcohol and other substances harmful to the liver, as well as maintaining a healthy diet and regular physical activity, can help strengthen the immune system and reduce the risk of infection.

Prevention of hepatitis B is a complex task that requires cooperation among healthcare professionals, public health institutions, and the public. Vaccination, education, and proper risk management can significantly reduce the risk of infection and associated complications.


Information sources:

  1. World Health Organization (WHO)
  2. Centers for Disease Control and Prevention (CDC)
  3. European Association for the Study of the Liver (EASL)
  4. "Hepatology"

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