Hepatitis B (HBV) is an infectious liver disease caused by the HBV virus. It can proceed as an acute infection or become chronic, which after years increases the risk of cirrhosis and hepatocellular carcinoma.
How infection occurs and who is the source?
The source (reservoir) is humans – an infected person (also asymptomatic).
Infection occurs mainly through contact with blood and body fluids (including semen, vaginal secretions), e.g., during unprotected sexual contact, sharing needles/injection equipment, needlestick injuries, procedures with interruption of tissue continuity, and from mother to child during childbirth.
HBV is very "resistant" in the environment – it can remain infectious on surfaces for at least 7 days.
Incubation period
Usually about 1.5–6 months; sources give a range of roughly 45–180 days.
Who is most at risk?
newborns born to persons infected with HBV,
people with multiple sexual partners / not using condoms,
people injecting drugs,
medical personnel and people exposed to needlestick injuries/exposure to blood,
people originating from or staying for a long time in countries with high HBV prevalence.
2. Symptoms of Hepatitis B
Most common symptoms of acute Hepatitis B (some infections are asymptomatic):
weakness, fatigue, malaise,
nausea, vomiting, lack of appetite,
abdominal pain,
dark urine, sometimes pale stools,
yellowing of the skin and whites of the eyes (jaundice),
possible joint pain, itching of the skin, occasionally rash.
Course of the disease
In many people, the infection is mild or asymptomatic, but in some, it may require hospitalization.
Rarely, fulminant hepatitis (life-threatening condition) may occur.
Chronic Hepatitis B often gives no clear symptoms for a long time, while damaging the liver.
Possible complications
chronic hepatitis,
cirrhosis of the liver,
hepatocellular carcinoma,
in advanced stages: liver failure.
When to urgently contact a doctor?
rapidly increasing jaundice, very dark urine + clear weakness,
severe, persistent vomiting/dehydration, severe abdominal pain,
disturbances of consciousness, drowsiness, bleeding, easy bruising,
any case of suspected exposure to blood (e.g., needlestick injury) – the sooner, the better.
3. Where does Hepatitis B occur?
Hepatitis B is a cosmopolitan disease – it occurs all over the world. The highest burden of chronic HBV is observed in many countries of Sub-Saharan Africa as well as East Asia and the Western Pacific region (in some countries prevalence is very high).
For whom is this information most important?
for people traveling to countries with higher HBV prevalence (longer trips, work, volunteering, backpacking),
for people planning medical or cosmetic procedures abroad,
for people who may have risky sexual contacts during travel.
4. How to protect yourself against Hepatitis B?
A. General prevention
Safer sex: condoms reduce the risk of infection.
Avoid contact with blood: do not use shared needles/injection equipment, do not borrow razors, manicure tools.
Procedures (tattoo/piercing/cosmetics/medicine): choose places with a high standard of hygiene, disposable equipment, and sterilization.
After a needlestick injury or other exposure to blood – urgent consultation, because time matters.
B. Vaccination
This is the most effective method of protection.
Type of vaccine
Vaccines containing HBs antigen are used (vaccines against HBV have a very good safety profile).
For whom recommended?
for anyone who has not been vaccinated or is not sure if they have immunity,
especially: people traveling to regions with higher HBV prevalence, people at risk of exposure to blood, sexually active people with new/multiple partners, medical personnel.
Vaccination schedule
The most common schedule is 3 doses: 0–1–6 months.
In situations where you need protection faster, some preparations have accelerated schedules (e.g., 0–1–2 months with a supplementary dose later or 0–7–21 days with a dose after 12 months – depending on the preparation and indications).
Booster doses
In people with normal immunity after a full vaccination cycle, routine booster doses are usually not recommended.
Exceptions may be selected groups (e.g., severe immunodeficiencies, some dialysis patients) – then the doctor decides based on risk and possible antibody level tests.
How long does immunity last?
Protection after full vaccination is long-lasting, which is one of the reasons for the lack of routine boosters in immunocompetent people.
Additional notes
If you do not know if you were vaccinated or if you have immunity, this can be clarified by tests.
Before vaccination, there is always a qualification (interview, assessment of contraindications).
5. Summary
Hepatitis B is an infection that often gives no symptoms for a long time, but can lead to cirrhosis and liver cancer. The surest protection is vaccination, particularly important for unvaccinated people, those exposed to contact with blood, sexually active people, and those traveling to regions with higher HBV prevalence. It is best to start the cycle in advance (optimally a few months before travel), but if necessary, accelerated schedules selected individually also exist.