Hepatitis B and D

Most cases of hepatitis B are short-lived (doctors call this acute hepatitis B) and may only require bedrest and extra fluids. Acute hepatitis B may not cause symptoms, or it may result in issues -- for instance, fatigue or abdominal pain -- that range from mild to severe. If you recover from acute hepatitis, you’re immune for the rest of your life. 

Approximately 10% of people with acute hepatitis B develop the chronic -- or long-lasting -- form of the disease. Babies and children with acute hepatitis B are at higher risk for developing chronic hepatitis B. In fact, the younger you are when you get hepatitis B, the higher your risk of chronic infection. Symptoms may take years to appear, and people can be infected without knowing it. Sometimes chronic hepatitis B goes undetected for decades and is only diagnosed when serious liver disease is present.

Hepatitis D -- the most serious form of hepatitis -- only occurs in people who are already infected with the hepatitis B virus. Most people with hepatitis D do not show symptoms at first. For others, hepatitis B symptoms may get worse. People can become infected with both viruses at the same time -- called coinfection -- or get hepatitis D after being infected with hepatitis B -- called superinfection. Having both forms of hepatitis can increase your risk for liver damage and liver cancer.

A blood test can detect the hepatitis B and D viruses in your body and tell your doctor if hepatitis B is acute or chronic. It can also determine if you’ve already had hepatitis B and are now immune to it.

Your doctor might remove a small sample of your liver for testing to check for liver damage. 

A noninvasive form of ultrasound called FibroScan can determine the extent of scarring within the liver, also known as fibrosis, that has resulted from a hepatitis B or D infection. 

Imaging tests may be used to screen for liver cancer in people with advanced scarring.

If you have been exposed to hepatitis B, your doctor may recommend a vaccination. When given within 24 hours of exposure, it can prevent hepatitis B infection. The vaccine has been available in the U.S. since 1991 for all newborns and is required for school entrance in many states. It is also recommended for people ages 59 and younger who have not been vaccinated and for adults age 60 years or older who are at increased risk for infection. 

Duke offers the latest antivirals for hepatitis B. These medications, which are taken as a pill once a day, can stop or slow the reproduction of the hepatitis B virus. Currently, medications for treating hepatitis D are being tested and may soon be available. There are many types of antiviral medications available, and your doctor will determine which is best for you.

These medications boost your immune system to help get rid of the hepatitis B virus. They are given as injections for six months to one year.

A liver transplant may be the best option if you have severe liver damage or liver cancer. Your treatment team will carefully evaluate your condition to determine if this is the right option for you.