What is hepatitis B?

Hepatitis B is an inflammation of the liver which is caused by the hepatitis B virus. In most cases, a hepatitis B infection in adults is acute, in which case the body is able to overcome the virus by itself without the risk of contracting hepatitis B again. However, hepatitis B can become chronic in up to 10% of those affected, in other words, the virus can still be detected in the blood 6 months after infection and can also infect other people.1 Patients with chronic hepatitis B also have an increased risk of cirrhosis of the liver and liver cancer.2

Read more about how cirrhosis can develop and its effects here.

Acute hepatitis B is rarely cured in young children and people with a weakened immune system and becomes chronic in up to 90% of cases.1

Here you can watch a video that explains hepatitis B


Hepatitis B is one of the most common infectious diseases:1

  • About 2 billion people worldwide have been or are infected with the hepatitis B virus1
  • There are approximately 1.5 million new infections per year3
  • Just under 7,000 hepatitis B cases (chronic and acute) were reported in Germany in 2020; the number of unreported cases is probably much higher22

Hepatitis B is very contagious. It is mainly transmitted by blood, but can also be found in other bodily fluids such as saliva, tears, semen and vaginal secretions. The viruses are most frequently transmitted during

  • Unprotected sexual contact (without a condom) with infected partners
  • Use of non-sterile needles and sharing sniffing tubes when consuming drugs
  • Tattooing or piercing if infected needles/instruments are used
  • Shared use of personal care products, e.g. razors1

Hepatitis B can go undetected for quite a long time since it is often not noticeable and typical signs of the disease are lacking. You should be alert and consult a doctor if you notice the following symptoms over a long period of time:1

  • Nausea and vomiting
  • Loss of appetite
  • Feeling ill (malaise)
  • Fever
  • Joint pains
  • Possible yellowing of the skin and eyes (jaundice)
  • Dark urine, light stool

Blood is tested for antibodies against the virus and various virus components in order to detect a hepatitis B infection.1

People who are legally insured and over 35 years of age also have the opportunity to be tested once for hepatitis B (and also C) free of charge as part of the “health check-up”.4

Since infected mothers can transmit the virus to their child during birth, pregnant women are screened for hepatitis B as early as possible.5 Hepatitis D should also be tested for if the hepatitis B virus has been detected. Contracting hepatitis D at the same time can have a negative effect on the progression of liver disease.1

An acute hepatitis B infection in adults usually resolves without consequences and the symptoms disappear by themselves after a few weeks.1 When hepatitis B has become chronic, however, it is necessary to visit the doctor regularly so that the progression of the disease can be monitored and changes in the liver can be detected at an early stage.6 In principle, drug therapy is an option. There are two options available for this:1

  1. PEG-Interferon-alpha
    • can be used for a limited time, but not suitable for all patients
  2. special medicinal products that are aimed directly at the virus
    • inhibit the virus from multiplying
    • often have to be taken on a long-term basis

Hepatitis B is not curable in most cases, but early treatment can reduce the risk of developing cirrhosis or liver cancer.1,3 It is up to the doctor treating you to decide which form of treatment is best for you.

There has been a very effective and well-tolerated vaccination against hepatitis B since 1982, which is recommended for babies as young as 2 months.1,6 It is the best protection against infection with the hepatitis B virus. Anyone who has been vaccinated against hepatitis B cannot contract hepatitis D either.

The risk of infection can also be reduced by avoiding contact with the blood and other bodily fluids of infected people as much as possible, for instance through the following behaviours and measures:1

  • Safer sex (condoms reduce the risk, but do not fully eliminate it)
  • Use your own injecting equipment and paraphernalia for intravenous and nasal drug use, never share with others
  • It is essential that the instruments used for tattooing and piercing are sterile
  • Never share personal hygiene products that might be contaminated with blood, such as razors

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  1. RKI guide to hepatitis B and D. https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_HepatitisB.html (retrieved October 2023).
  2. RKI, Epidemiological Bulletin 29/2021.
  3. Hepatitis B. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b (retrieved October 2023).
  4. Association of Statutory Health Insurance Physicians – Practice Information. https://www.kbv.de/media/sp/Praxisinformation_Gesundheitsuntersuchung.pdf (Retrieved October 2023).
  5. Federal Joint Committee (2023) Guidelines of the Federal Joint Committee on Medical Care during Pregnancy and after Delivery (“Maternity Guidelines”). https://www.g-ba.de/downloads/62-492-3191/Mu-RL_2023-04-20_iK-2023-06-30.pdf (retrieved October 2023).
  6. Cornberg M et al. Z Gastroenterol 2021; 59: 691–776.