11:20 AM

Hepatitis B: know the risks and symptoms


This is part one of a two part story on hepatitis B. Click here to learn about treatment and prevention of the disease.

Hepatitis illustration

A new CDC recommendation says all adults should be screened for hepatitis B at least once.

It's a reminder about a disease, that, thankfully, experts say we don't need to think about daily.

David Rzepczynski, MD, a gastroenterologist at OSF HealthCare in Urbana, Illinois, explains that while there are many types of hepatitis – A, B, C, D and E – they all describe inflammation of the liver.

How it’s spread

Dr. Rzepczynski says hepatitis B is most commonly spread through bodily fluids like blood, saliva and fluids from the genital area.

A common scenario, he says, is young adults spreading the disease by sharing needles to inject drugs. Sexual relations between people who are infected can also result in the spread.

And there are everyday scenarios. Someone may share a toothbrush or a shaving razor with a person close to them. Children may be roughhousing outside and get a cut, exposing their blood to others.

But Dr. Rzepczynski stresses hepatitis B doesn’t have to be a chief concern when, for example, your kids are at the playground. Just make sure they avoid contact with blood. And ideally, families, roommates and partners would know ahead of time if the people they are around have the virus or have been exposed.

Something else you don’t need to worry about in 2023: getting hepatitis B from donated blood.

“That’s almost nonexistent now,” Dr. Rzepczynski says, due to advances in testing.

“The blood bank works to evaluate a blood donation in terms of the risk of contracting and transmitting hepatitis B to another person,” Dr. Rzepczynski says. “Right now, the risk is maybe one out of a million.”


Not all people who get hepatitis B show symptoms. But those who get an acute, sudden infection may experience fatigue, nausea, loss of appetite, pain in the upper right abdomen and – for smokers – less desire to light up.

Dr. Rzepczynski says around 30% of people with acute hepatitis B develop jaundice, the hallmark symptom of liver disease.

“Yellow jaundice is a condition where the skin will have a yellowish tint to it. The whites of the eyes will have a yellowish tint to them,” Dr. Rzepczynski says. “Sometimes it can be very subtle. Depending on the light, you may not even notice it. The other extreme: a person might look like they’re ready for Halloween. They look like a pumpkin.”

The chief long-term effect of hepatitis B, in terms of decades, not months, Dr. Rzepczynski says, is cirrhosis of the liver, which can be life-threatening.

“When you develop scarring of the liver and there’s a buildup of scar tissue, you can develop a liver that’s shrunken in size. It’s not functioning as well because there’s a loss of liver cells from the scarring,” he says.

Interview clips

View Dr. David Rzepczynski on blood donations
Dr. David Rzepczynski on blood donations
View Dr. David Rzepczynski on jaundice
Dr. David Rzepczynski on jaundice
View Dr. David Rzepczynski on liver scarring
Dr. David Rzepczynski on liver scarring