What is Hepatitis B? Symptoms, Transmission, and Treatment

Hepatitis B is a contagious infection targeting the liver, caused by the Hepatitis B virus (HBV). This virus leads to liver inflammation, setting the stage for both short-term complaints and chronic, lifelong health issues. When detected early and managed with the right steps, the disease can be kept under control. However, if neglected, it carries the potential to cause severe liver damage.

In short:

• It is a viral disease affecting the liver, transmitted through blood and body fluids.
• Fatigue, loss of appetite, dark urine, and jaundice are among the most common symptoms.
• The Hepatitis B vaccine is the safest and most effective way to prevent the disease.
• A positive HBsAg test indicates the presence of an active virus in the body.
• If it becomes chronic, it carries serious risks such as cirrhosis and liver cancer.

What is Hepatitis B?

Hepatitis B is a viral disease that settles in liver cells, multiplies there, and prevents the organ from performing its normal functions. Once the virus enters the body, the immune system launches a strong defense against this foreign organism. The inflammation in the liver is actually the result of the immune system attacking the infected cells, rather than the virus itself. This process directly affects the liver's ability to clear toxins, produce bile, and process nutrients.

The disease is primarily evaluated in two distinct stages: acute and chronic. Acute Hepatitis B covers the six-month period following the initial contact with the virus. The vast majority of adults, thanks to their strong immune responses, overcome this stage, recover completely, and gain lifelong immunity against the virus. Chronic Hepatitis B, on the other hand, occurs when the virus remains in the body for longer than six months. The likelihood of the disease becoming chronic is much higher, especially in individuals who contract the virus during infancy or early childhood. Chronic infection can progress silently for years without showing any symptoms, gradually damaging liver tissue.

Causes and Risk Factors

The sole cause of the disease is the Hepatitis B virus. This virus is quite resilient in external environments and can remain alive and capable of causing infection for at least seven days, even in dried blood drops outside the body. The spread of the virus is directly related to certain behaviors and occupational exposures. Some groups in society are considered at risk because they have a higher probability of encountering the virus.

People who frequently come into contact with blood and body fluids or patients with suppressed immune systems fall into this group. The primary at-risk groups include:

• Patients undergoing hemodialysis treatment and organ transplant recipients.
• Individuals who frequently need to use blood and blood products.
• People with intravenous substance addiction who share syringes.
• Unvaccinated family members sharing the same household with a Hepatitis B carrier.
• Individuals with multiple sexual partners or those engaging in unprotected intercourse.
• Those who get tattoos, piercings, or cupping therapy (hacamat) in places that do not follow sterilization rules.
• Healthcare professionals, including doctors, nurses, 112 emergency personnel, and cleaning staff working in medical institutions.

What Are the Symptoms of Hepatitis B?

Although the incubation period of the disease varies from person to person, symptoms typically appear between 45 and 160 days after contact with the virus. While about half of adult patients experience noticeable complaints, the disease usually progresses silently in babies and children. The severity of the symptoms depends on the person's general health and the strength of their immune system.

Even when entering the recovery phase and acute signs like jaundice and loss of appetite disappear, the feeling of fatigue caused by the disease can persist for weeks or even months. The most common Hepatitis B symptoms encountered during the acute infection phase are:

• Extreme weakness, a feeling of fatigue that does not go away with rest, and loss of energy.
• Nausea, vomiting episodes, and a significant loss of appetite for food.
• Abdominal pain, especially in the upper right quadrant where the liver is located, just below the ribs.
• Mild fever, headache, and a general feeling of malaise.
• Migrating pains in the muscles and joints.
• Darkening in urine color (resembling dark tea or cola) and lightening of stool color (like putty).
• Noticeable yellowing in the whites of the eyes and on the skin surface (jaundice).

How is Hepatitis B Transmitted?

Understanding the transmission dynamics of the disease is a critical step in protecting yourself and your loved ones. The virus is not transmitted through social contact, shaking hands, hugging, being in the same environment, breathing the same air, or eating from the same plate. For transmission to occur, the infected person's blood or body fluids must come into direct contact with the healthy person's bloodstream or mucous membranes.

Hepatitis B transmission routes, much like the HIV virus, primarily occur through blood and sexual contact. To better understand similar risks in this regard, you can also review our article titled What is AIDS, How is it Transmitted. The most common modes of transmission are the use of unsterilized medical instruments, sharing syringes, and unprotected sexual intercourse. Additionally, transmission from mother to baby during childbirth is one of the most common transmission routes worldwide.

The shared use of personal care products we use in daily life, such as razor blades, toothbrushes, or nail clippers, also allows the virus to pass through micro-cuts. Inadequate sterilization of manicure and pedicure tools used in beauty centers or hair salons poses a serious risk factor for infection.

Ways to Protect Yourself

The Hepatitis B vaccine is the safest and most effective method of protection against the disease. In our country, this vaccine, which is part of the routine vaccination schedule during infancy, is also safely administered to adults in risk groups. The vaccine prepares the body against potential exposures by ensuring the production of antibodies against the virus.

In addition to vaccination, paying utmost attention to personal hygiene rules is of great importance. Items that can cause bleeding, such as razors, toothbrushes, and earrings, should never be shared. Using a condom during sexual intercourse is one of the fundamental protective steps. Checking the hygiene certificates and autoclave devices of the places where tattoos, piercings, or medical aesthetic procedures will be performed helps protect your health.

Diagnosis: How is it Diagnosed in the Hospital?

The diagnosis of the disease is made through a detailed physical examination and specific blood tests performed by a specialist physician. During the examination, the physician looks for signs of liver enlargement, tenderness to the touch, or jaundice on the skin. However, serological blood tests are essential for a definitive diagnosis. These tests clearly reveal the stage of the virus and the response given by the immune system.

One of the questions patients wonder about most regarding blood tests is what HBsAg positive means. HBsAg (Hepatitis B surface antigen) is a protein found on the outer surface of the virus. A positive result for this value indicates that the person has an active virus in their body and can transmit the disease to others. The HBsAg value can be detected in the blood approximately one to two months before clinical symptoms begin.

During the diagnostic process, biochemical tests measuring liver enzymes (ALT, AST) and ultrasonography to evaluate the physical structure of the liver are also used. If the disease has become chronic, a liver biopsy may be required to determine the degree of damage to the liver and shape the treatment plan.

How is Hepatitis B Treated?

The treatment of the disease differs entirely depending on whether the infection is acute or chronic. In acute Hepatitis B infections, specific drug treatment targeting the virus is generally not needed. The body fights the virus on its own through the immune system and overcomes the infection.

During the acute phase, resting at home, consuming plenty of fluids, and eating a healthy diet are essential. Alcohol consumption, which can strain the liver, unnecessary use of painkillers or antibiotics, and herbal supplements without a doctor's approval must be strictly avoided. The physician monitors the patient's condition with regular blood tests, waiting for liver enzymes to return to normal.

Chronic Hepatitis B treatment, on the other hand, aims to stop the multiplication of the virus and prevent liver damage. In this process, oral antiviral medications or interferon treatments administered as injections are used. The treatment is usually long-term, and it is extremely important for patients to take their medications in the order recommended by the physician, without missing their times. The viral load in the blood (HBV DNA) and liver functions are closely monitored with regular check-ups.

Complications and Risk Groups

In about 1 to 2 percent of individuals who experience an acute infection, a very severe condition called fulminant hepatitis, where the liver rapidly fails, can develop. This situation is life-threatening and requires immediate medical intervention, even a liver transplant. However, the real major danger arises when the disease silently becomes chronic.

Chronic liver disease can turn into cirrhosis over time, where healthy liver tissue is replaced by hard scar tissue. Patients who develop cirrhosis may experience serious problems such as fluid accumulation in the abdominal cavity (ascites) and esophageal varices. Furthermore, the risk of liver cancer (hepatocellular carcinoma) is much higher in these patients compared to healthy individuals. These complications cause hundreds of thousands of people to lose their lives worldwide every year.

Deteriorations in liver functions can also deeply affect the body's overall metabolic balance. Insulin resistance and thyroid dysfunction are common in advanced-stage liver diseases. For a comprehensive evaluation of issues like blood sugar regulation and hormone balance, multidisciplinary support from the Endocrinology and Metabolism department of our hospital may also be required. If you want to understand the foundations of metabolic problems, you can also take a look at our article titled What is Goiter?.

When to See a Doctor?

Anyone who suspects they have Hepatitis B or thinks they have had risky blood contact should consult a healthcare institution without delay. Tests performed in the early period and, if necessary, protective antibody (immunoglobulin) treatments can prevent the virus from settling in the body. Furthermore, it is essential for chronic carriers to go for regular doctor check-ups every six months, even if they have no complaints.

Some symptoms can be harbingers of liver failure or a serious complication. If you experience any of the following emergency warning signs, you should immediately apply to the nearest emergency room or call 112:

• Sudden onset, progressively darkening deep jaundice on the skin and in the whites of the eyes.
• Clouded consciousness, excessive sleepiness, confusion, or difficulty speaking.
• Unstoppable severe vomiting or vomiting blood that looks like coffee grounds.
• Rapid and noticeable swelling (fluid accumulation) in the abdominal area.
• Unexplained bruising or non-stopping bleeding in various parts of the body.

The Process at BHT CLINIC

At BHT CLINIC İstanbul Tema Hastanesi, the diagnosis and treatment of liver diseases are meticulously carried out by our expert medical staff. From the moment you apply to our hospital, all your necessary serological and biochemical tests are finalized quickly and reliably thanks to our modern laboratory infrastructure.

In our JCI-accredited hospital, we have a fully equipped emergency room that provides 24/7 service for emergencies such as acute hepatitis crises or suspected fulminant hepatitis. In cases requiring chronic follow-up, our Gastroenterology, Infectious Diseases, Internal Medicine, and Endocrinology departments work in coordination to create the most appropriate treatment plan for you.

To secure your health, learn your vaccination status, or have your chronic hepatitis followed up, you can call our call center at 0850 811 34 00 or consult with our specialist physicians by booking an appointment through our website.

Frequently Asked Questions

Can Hepatitis B be completely cured?

Approximately 95 percent of acute Hepatitis B infection cases experienced during adulthood recover completely, and the person gains lifelong immunity against the virus. However, when the disease becomes chronic, the virus may not be completely cleared from the body; in this case, the treatments applied aim to stop the virus from multiplying and protect the liver.

How many doses of the Hepatitis B vaccine are administered?

The standard Hepatitis B vaccination schedule is generally administered in three doses into the muscle of the arm. The second dose is given one month after the first dose, and the third dose is given six months after the first dose. This three-dose regimen provides strong protection of over 90 percent in healthy individuals.

What does HBsAg positive mean?

A positive HBsAg value in a blood test indicates that the Hepatitis B virus is present in your blood and that you are actively carrying the disease. This situation can indicate the beginning of an acute infection or be a sign of chronic carriage that has been ongoing for years.

Can Hepatitis B patients get married?

Yes, Hepatitis B patients can get married. The condition is detected during mandatory premarital blood tests, and if the prospective spouse is unvaccinated, they are immediately included in a vaccination program. Once the vaccination is complete, the risk of transmission to the spouse is completely eliminated.

Can Hepatitis B pass from mother to baby?

Yes, although rare during pregnancy, the virus can pass from mother to baby, especially during childbirth. To prevent this risk, the Hepatitis B vaccine and Hepatitis B immunoglobulin (protective antibody) are administered to the baby within the first 12 hours immediately after birth, preventing the baby from becoming infected.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.