Hepatitis B (chronic): diagnosis and management

Chronic hepatitis B

Chronic hepatitis B occurs in people who are infected with the hepatitis B virus (or HBV for short). The virus passes from one person to another through contact with infected blood or body fluids, most commonly through unprotected sex, sharing equipment to inject drugs, or from mother to baby during or after birth. Many people who become infected with HBV develop a short-term (acute) infection and then clear the virus naturally. Some people develop a long-term infection, which is known as chronic hepatitis B.

HBV infection is diagnosed by having a blood test. People who are infected with HBV will test positive for a protein that sits on the surface of the virus (called hepatitis B surface antigen, or HBsAg). People who remain HBsAg positive for at least 6 months are diagnosed with chronic hepatitis B.

Chronic hepatitis B affects the liver and can cause serious health problems if left untreated. These include scarring of the liver (called fibrosis or cirrhosis), liver failure (called decompensation) and liver cancer (called hepatocellular carcinoma, or HCC). Drug treatments are available that substantially reduce the risk of developing these conditions. Although treatment leads to a full recovery in some people, most people with chronic hepatitis B will need lifelong treatment.

Often people with chronic hepatitis B do not have any symptoms. This means that they may need to start treatment as their condition develops, even though they may not feel unwell. It is therefore very important that the person understands and adheres to treatment and monitoring as prescribed.