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Can Hepatitis B cause injury and/or death?

Updated February 16, 2023

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For most people hepatitis B is not a deadly disease. Symptoms of acute hepatitis B disease usually begin within one to four months of exposure and include nausea, vomiting, fatigue, low grade fever, pain and swelling in joints, headache, cough and jaundice (yellowing of the skin or eyes). Fatigue and malaise may persist for weeks or months during recovery, as symptoms subside.  Fifty percent of adults infected with hepatitis B have will have no symptoms.  Hospitalization for acute hepatitis B is low and limited to the elderly, individuals with pre-existing medical conditions and those who require treatment for dehydration from severe nausea and vomiting.  On very rare occasions, acute hepatitis B infections can lead to liver failure and death.

Approximately five percent of adults do not recover completely and will become chronic carriers of the virus. Of this number, only 15 percent will develop life-threatening liver disease such as cirrhosis or liver cancer.  Chronic infection requires monitoring and avoidance of alcohol and smoking to avoid liver damage.  Persons who develop chronic hepatitis B infection during childhood have about a 25 percent risk of dying from a serious hepatitis B complication such as liver cancer or cirrhosis. 

In 1988, the Advisory Committee on Immunization Practices (ACIP) recommended that all pregnant women be screened to identify hepatitis B positive expectant mothers and allow for immediate treatment of their newborns with hepatitis B immune globulin (HBIG) and the hepatitis B vaccine. This recommendation was put forth due to the high rate of transmission from hepatitis B positive mothers to their newborns. All pregnant women are now routinely screened early in pregnancy for both hepatitis B surface antigen (HBsAg) and Hepatitis B "e" antigen (HBeAg). 

Studies indicate that 90 percent of infants born to a mother who is both positive for HBsAg and HBeAg and between five percent and 20 percent of infants born to a mother who is HBsAg positive but HBeAg negative, will become infected without treatment at birth. Treatment with hepatitis B immune globulin (HBIG) and the hepatitis B vaccine within 24 hours of birth is estimated to be 85 to 95 percent effective in preventing chronic hepatitis B infection in infants born to hepatitis B positive mothers. 

Although much attention is focused on the risk of perinatal transmission, a 1996 report issued by the U.S. Preventative Services Task Force, an organization comprised of nationally recognized experts in prevention, evidence-based medicine, and primary care, stated infections during infancy were “estimated to represent only one to three percent of all hepatitis B cases.”  However, more recent research indicates rates in the use are likely to be much lower. 

Those who recover completely from hepatitis B infection acquire life-long immunity. 

IMPORTANT NOTE: NVIC encourages you to become fully informed about Hepatitis B and the Hepatitis B vaccine by reading all sections in the Table of Contents , which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.


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