The immune reaction results in active liver inflammation, which can injure the liver. Immune clearance: This phase begins when the immune system recognizes the presence of the virus in the body and attacks the infected liver cells. Immune tolerance: This early phase of chronic hepatitis B is characterized by high viral replication and weak immune response, which results in high viral load. If an acute hepatitis B infection does not clear in six months, it is considered to be chronic. However, the virus’ genetic materials still reside in their liver and can be reactivated in the future especially if the person takes medicines that profoundly suppress their immune system. If there is no hepatitis B virus present in the blood and the antibodies have formed, it means the person has cleared the infection and they cannot pass it on to someone else. Immune adults will have a not-detectable result on a hepatitis B surface antigen (HBsAg) test, a detectable result on an anti-hepatitis B surface antibody (anti-HBsAb) test and a detectable result on an anti-hepatitis B core antibody (anti-HBcAb) test. Blood tests can be done six months after diagnosis to determine whether a person is immune. Most adults clear the virus on their own within six months and become immune to it. When this occurs, symptoms of advanced liver disease, like bleeding or bruising more easily, brain fog or confusion, and jaundice, can be seen. About one percent of people in the acute phase can experience liver failure. Symptoms, when they do appear, may include fatigue, loss of appetite, jaundice, (yellowing of the whites of the eyes and skin), nausea, vomiting, rash, dark urine, joint discomfort or pain, and abdominal discomfort or pain. During this phase, there are few or no symptoms in most children (over 90 percent) and in many adults (50–70 percent). During the acute infection, the virus is highly active and can be passed to others. In adults, this phase can last for two to six weeks. Please see the section on hepatitis B in infants and pre-adolescent children for further details.Īn acute infection begins immediately after exposure to the hepatitis B virus. Children exposed to the virus between the ages of one and five years have a 30 percent chance of developing a chronic infection. Without medical intervention, newborns exposed to the virus during pregnancy have a 90 percent chance of developing a chronic infection. Infants and children have a significantly higher likelihood of developing a chronic infection, especially those born to a pregnant person who has hepatitis B.Most adults (95%) clear the virus on their own within six months of exposure.The age at which someone is exposed to the virus plays a major role in determining whether the infection will resolve or become chronic. The virus can cause an acute infection, which may develop into a chronic infection over time. Hepatitis B is a virus that can infect the liver.
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