is a disease caused by the hepatitis B virus (HBV). This virus attacks the liver. The disease can cause:
HBV is spread through the blood or other body fluids of an infected person.
Certain factors increase the risk of developing hepatitis B, including:
- Having sex with someone infected with HBV
- Having multiple sexual partners
- Injecting illegal drugs
- Having male homosexual sex
- Living in the same house as someone with chronic hepatitis B
- Coming in contact with human blood
- Working in the home of someone who is developmentally disabled
- Traveling to areas where hepatitis B is common
- Having parents born in Southeast Asia, Africa, the Amazon Basin in South America, the Pacific Islands, or the Middle East
About 30% of people with hepatitis B will not have symptoms. For people who do, symptoms may include:
Yellowing of the skin and eyes (
- Fatigue that lasts for weeks or even months
- Abdominal pain in the area of the liver (upper right side)
- Loss of appetite
- Joint pain
- Low-grade fever
- Dark urine and light-colored stool
- Widespread itching
Symptoms generally occur about 12 weeks after exposure. They can occur anywhere from 9-21 weeks after exposure. Most hepatitis B infections clear up within 1-2 months without treatment. But when an infection lasts more than six months, it can develop into chronic hepatitis B. This can lead to serious complications, even death.
Chronic hepatitis B can be treated with antiviral drugs.
The hepatitis B vaccine is produced by inserting a gene for HBV into yeast. The yeast is grown, harvested, and purified. The vaccine is given as an injection into the muscle.
Newborns routinely receive the first dose of the hepatitis B vaccine before leaving the hospital. If the mother is infected with the virus, the dose is given within 12 hours of birth. Two more injections are given to all infants at:
Depending on the type of vaccine, some babies may receive 4 doses.
Children and teens (aged 18 years or younger) who have not been immunized as babies can also get the vaccine. For children aged 11-15 years, there is a two-dose series available, called Recombivax HB.
It is recommended that adults (aged 18 years or older) get vaccinated if they are at high risk for hepatitis B. High risk includes:
- Having multiple sex partners
Getting treatment or counseling for a
sexually transmitted disease
- Being a man who has sex with other men
- Being an IV drug user or having a history of injecting drugs
chronic kidney disease, liver disease, or
- Having diabetes (if younger than 60 years old)
- Having a job where you might be exposed to HBV-infected blood or body fluids (eg, medical facility, correctional facility)
- Working or living in an institution for the developmentally disabled
- Living with or working with people who have chronic HBV infection
- Traveling to areas where there is a high rate of HBV infection
All vaccines are capable of causing serious problems, such as a severe allergic reaction.
Most people who get the hepatitis B vaccine do not have problems. Some may have mild problems, including soreness where the shot was given and fever.
(eg, Tylenol) is sometimes given to reduce pain and fever that may occur after getting a vaccine. In infants, the medicine may weaken the vaccine's effectiveness. Discuss the risks and benefits of taking acetaminophen with the doctor.
You should not get the vaccine if you:
- Had a life-threatening allergic reaction to baker's yeast or to a previous dose of hepatitis B vaccine
- Are moderately or severely ill—Wait until you recover to get the vaccine.
Other than getting the hepatitis B vaccine, the best methods of preventing an HBV infection include:
- Practicing safe sex
- Getting a blood test for hepatitis B if you are pregnant
- Avoiding illegal drugs
- Not using other people's personal care items that may have blood on them (eg, razors, toothbrushes)
- Considering the risks before getting a tattoo or body piercing
- Following safety precautions when handling needles or other sharp objects
In the event of an outbreak, all susceptible people should be offered the vaccine.
WHERE CAN I GET MORE INFORMATION?
Baker CJ, Pickerling LK, Chilton L, et al. Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2011.
Ann Intern Med.
Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2011.
Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010.
Hepatitis B. National Center for Infectious Diseases website. Available at:
. Accessed February 6, 2007.
Hepatitis B. US Centers for Disease Control and Prevention website. Available at:
. Accessed February 6, 2007.
Hepatitis B vaccination. US Centers for Disease Control and Prevention website. Available at:
. Accessed February 6, 2007.
Recommended immunization schedules for persons aged 0-6 years—United States, 2012. Centers for Disease Control and Prevention website. Available at:
. Published December 23, 2011. Accessed February 10, 2012.
Vaccine information statement: hepatitis B vaccine. Centers for Disease Control and Prevention website. Available at:
. Updated February 2, 2012. Accessed February 10, 2012.
1/31/2008 DynaMed's Systematic Literature Surveillance
: Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at:
. Updated January 10, 2008. Accessed January 28, 2008.
10/30/2009 DynaMed's Systematic Literature Surveillance
: Prymula R, Siegrist C, Chlibek R, et al. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials.
Last reviewed June 2012 by Lawrence Frisch, MD, MPH
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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