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Chronic vs. Acute Hepatitis B

Instructor: Alexandra Unfried

Alexandra earned her master's degree in nursing education and is currently a hospital supervisor/administrator.

The hepatitis B virus infects the liver. It starts out as an acute infection that can become chronic and cause serious liver damage. This lesson will discuss the differences between acute and chronic hepatitis B.

Viral Infection

Cathy has not been feeling well for the past week. She has flu-like symptoms such as nausea, fever, and weakness. She notices that her urine is darker than usual even though she has been trying to drink a lot of fluids. Cathy decides to see a doctor and gets her blood tested. The blood work shows an infection and that she is positive for hepatitis B. Her doctor explains what hepatitis B is.

What is Hepatitis B?

Hepatitis B is a viral infection that attacks the liver. It is transmitted through body fluids such as blood, semen, saliva, and vaginal secretions. Therefore, hepatitis B is spread when having sexual intercourse, sharing medical or drug needles, and can be passed from mother to baby during childbirth. Hepatitis B moves through mucous membranes into skin that is open or cut. Hepatitis B can be prevented by avoiding risky behaviors and getting a vaccine.

Hepatitis B virus
Hepatitis B virus

Symptoms of hepatitis B are not always present and are usually general and vague. Once infected, it can take one to four months to show signs of an infection. Healthy adults usually have no symptoms. Symptoms are seen in infants, children, and those who are immunocompromised. Symptoms include:

  • Nausea/vomiting
  • Abdominal pain
  • Weakness/tiredness
  • Dark-colored urine
  • Fever
  • Decreased appetite
  • Joint pain
  • Jaundice (yellowing of the whites of eyes and skin that indicates liver damage)

Symptoms of hepatitis B are usually only present with acute hepatitis. Those with chronic hepatitis usually do not have any symptoms until the liver is damaged.

Cathy has never been diagnosed with hepatitis B before, so her infection is categorized as acute hepatitis B. The doctor asks Cathy if she has participated in any risky behaviors over the last several months. She tells the doctor that she did have unprotected sex with someone that she had just met. The doctor explains to Cathy that she may have gotten hepatitis B from that sexual partner. He then explains the differences between acute and chronic hepatitis B.

Acute Hepatitis B

Hepatitis B is considered acute if the infection lasts six months or less. Most adults can rid the body of the virus without treatment. Infants, children, and adults with symptoms require treatment. Treatment is simple and usually does not require any medications. However, if symptoms are severe, an antiviral medication may be prescribed. General treatment includes:

  • Drinking increased fluids
  • Following a healthy diet
  • Rest
  • Avoiding drugs or alcohol

Once the home treatments are done, and symptoms have ceased, a follow-up blood test is done to determine if the hepatitis B is still in the body. If there is a negative result, then there is no hepatitis B. The chance of another infection is rare because there are now protective antibodies in the blood. If the result is positive, and it has been more than six months since the diagnosis, hepatitis B is still present and considered a chronic infection.

Chronic Hepatitis B

Chronic hepatitis B occurs when the virus is still present in the body after six months. There are usually no symptoms, but the infection can still be passed to others. Even though there are generally no symptoms, hepatitis B can cause liver damage. Once liver damage is present, symptoms will appear. The symptoms are the same as for an acute infection but usually more severe. One common symptom of liver damage is jaundice. Regular blood tests and doctor visits are necessary to determine the activity and presence of hepatitis B. Antiviral medications, a liver biopsy, or a possible liver transplant may be needed if there are signs of liver damage.

Jaundice: yellowing of the skin
Jaundice: yellowing of skin

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