What are the symptoms of Hepatitis B (HBV)?

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Last updated: June 25, 2025View editorial policy

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From the Guidelines

Hepatitis B symptoms can range from mild to severe and include fatigue, poor appetite, nausea, vomiting, abdominal pain, low-grade fever, jaundice, dark urine, and light stool color, with approximately 30%--50% of persons aged >5 years exhibiting clinical signs or symptoms of acute disease after infection. According to 1, symptoms of acute hepatitis B typically begin 2--3 months after exposure and can last 2--4 months. It's essential to note that many people, especially infants, children, and immunosuppressed adults, may be asymptomatic.

When symptoms do appear, they can include:

  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Low-grade fever
  • Jaundice
  • Dark urine
  • Light stool color As mentioned in 1, clinical signs can also include jaundice, liver tenderness, and possibly hepatomegaly or splenomegaly.

In chronic hepatitis B infection, symptoms may be subtle or absent until liver damage becomes advanced, as stated in 1. The virus can cause significant morbidity and mortality, particularly in persons with chronic infection, emphasizing the importance of regular screening and early detection to prevent complications like cirrhosis and liver cancer.

From the Research

Symptoms of Hepatitis B

The symptoms of Hepatitis B (HBV) can vary, but common symptoms include:

  • Fatigue
  • Poor appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Low-grade fever
  • Jaundice
  • Dark urine
  • Hepatomegaly (enlargement of the liver)
  • Splenomegaly (enlargement of the spleen) 2

Acute and Chronic Infection

Acute HBV infection can be either asymptomatic or present with symptomatic acute hepatitis. Most adults infected with the virus recover, but 5%-10% are unable to clear the virus and become chronically infected 3. Chronic HBV infection can lead to a wide spectrum of liver disease, ranging from mild liver disease to cirrhosis, hepatocellular carcinoma, and liver cancer 3, 4.

Disease Progression

The progression of HBV infection can be influenced by various factors, including the age of infection, maternal transmission, and the presence of other liver diseases 4, 5. The risk of developing hepatocellular carcinoma (HCC) is higher in individuals with chronic HBV infection, particularly those who are infected at a younger age 4.

Extrahepatic Manifestations

Extrahepatic manifestations of HBV infection are rare but can be difficult to diagnose and manage 3. These manifestations can include a range of symptoms and conditions outside of the liver, highlighting the complexity of HBV infection.

Prevention and Treatment

Prevention of HBV infection through vaccination can reduce the incidence of liver cancer and other HBV-related diseases 4, 5. Treatment options for chronic HBV infection include antiviral agents and pegylated interferons, which can improve clinical outcomes by suppressing viral replication and reducing liver inflammation 2, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hepatitis B: diagnosis and treatment.

American family physician, 2010

Research

Hepatitis B: the virus and disease.

Hepatology (Baltimore, Md.), 2009

Research

Hepatitis B virus and cancer prevention.

Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer, 2011

Research

Improving clinical outcomes of chronic hepatitis B virus infection.

Expert review of gastroenterology & hepatology, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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