HEPATITIS B GUIDE 2025: SYMPTOMS, VACCINE, TREATMENT & RISK FACTORS

What Is Hepatitis B?

Hepatitis B is a viral infection that inflames the liver and can lead to chronic disease, cirrhosis, or even liver cancer. Transmitted through blood, bodily fluids, or from mother to newborn, hepatitis B is a global health concern, yet with vaccination, early diagnosis, and treatment, it is manageable and preventable. In this blog, you’ll learn about hepatitis B causes, symptoms, risk factors, special considerations for pregnant women and newborns, diagnosis, treatment options, lifestyle adjustments, and cutting-edge research happening in the UAE and beyond.

What Is the Hepatitis B Virus (HBV)?

The Hepatitis B virus (HBV) is a DNA virus that infects the liver and causes a disease known as hepatitis B. It belongs to the Hepadnaviridae family and is one of the most serious types of hepatitis.

Once inside the body, HBV targets liver cells (hepatocytes), where it multiplies and triggers an immune response. In some individuals, this immune response successfully clears the virus—leading to full recovery and long-term immunity. However, in others, particularly infants and those with weak immune systems, the infection can become chronic, leading to long-term complications like cirrhosis, liver failure, or liver cancer.

Key characteristics of the hepatitis B virus include:

• Highly infectious: HBV is 50 to 100 times more infectious than HIV.
• Stable in the environment: It can survive outside the body for up to 7 days.
• Transmitted via blood and bodily fluids: Common routes include unprotected sex, shared needles, blood transfusions (rare with modern screening), and mother-to-child transmission at birth.

The presence of hepatitis B surface antigen (HBsAg) in the blood indicates an active infection. Additional markers like hepatitis B e antigen (HBeAg) and hepatitis B DNA levels help determine how contagious the person is and guide treatment decisions.

Thanks to widespread hepatitis B vaccination, many countries, including the UAE, have seen dramatic declines in new infections. However, chronic hepatitis B remains a global health concern, especially in regions with lower vaccination coverage or poor access to medical care.

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What Causes Hepatitis B?

• Hepatitis B transmission occurs through infected blood, saliva, semen, or vaginal secretions.
• Common risk factors include unprotected sex, sharing needles, tattooing with unsterile equipment, and mother-to-child transmission at birth.
• In rare cases, transfusions or dental work in non-sterile settings may lead to infection.

A small percentage of people become chronic hepatitis B carriers, remaining contagious even without symptoms.

Who Is Considered a Hepatitis B Carrier?

A Hepatitis B carrier is someone who has been infected with the hepatitis B virus (HBV) and continues to have the virus present in their blood for more than six months even without symptoms. This means the virus is still in their system, even if they don’t have any symptoms or liver damage. Carriers are often identified by the continued presence of the hepatitis B surface antigen (HBsAg) in their blood. Some carriers also test positive for hepatitis B e antigen (HBeAg) or HBV DNA, which may indicate that the virus is active and they are more likely to spread it to others.

Can Hepatitis B Carriers Transmit the Virus?

Yes. Even if someone doesn’t have symptoms, a hepatitis B carrier can transmit the virus through:

• Unprotected sex
• Sharing razors, toothbrushes, or needles
• Blood transfusions (in areas without strict screening)
• From mother to baby during childbirth

What Should Hepatitis B Carriers Do?

• Avoid alcohol and liver-toxic drugs to reduce strain on the liver
• Get regular liver function tests and ultrasounds
• Avoid donating blood
• Inform close contacts so they can be vaccinated
• Practice safe sex
• Avoid sharing personal hygiene items
• Pregnant carriers should follow medical guidance to prevent newborn infection

Though being a carrier can sound alarming, many people live full, healthy lives with proper care, lifestyle adjustments, and regular medical follow-ups.

What are the Common Symptoms & Early Warnings of Hepatitis B?

Most people are asymptomatic in the early stages. If symptoms appear, they may include:

• Jaundice (yellowing of eyes & skin), dark urine, and clay-colored stools
• Fatigue, loss of appetite, nausea, and abdominal discomfort
• Fever, joint pain, and itchy skin rashes

What Tests Should You Take If You Suspect Hepatitis B?

If you believe you’ve been exposed to the hepatitis B virus (HBV), through unprotected sex, shared needles, contact with infected blood, or travel to high-risk areas, it’s essential to book a consultation with a gastroenterologist and get tested promptly.

Your doctor will request one or more of the following tests and will explain what each of them indicates about your case:

False positive tests occasionally occur; that’s why doctors assess the test results and may request you to repeat some of them or do further tests to confirm the diagnosis before treatment.

Regular monitoring of your hepatitis B antibody titer confirms whether vaccination produced immunity (anti-HBs >10 mIU/mL is the normal range).

How Many Doses of the Hepatitis B Vaccine Do You Need?

Standard schedule: 0, 1, 6 months (three doses), hepatitis B doses for adults and newborns

Baby vaccine: Administered within 12 hours of birth, essential to prevent vertical transmission

Booster needed? Generally, no for healthy individuals, but immunocompromised may benefit

Antibody titer testing after vaccination ensures protection; if low (out of range), booster is advised

What Are the Treatment Options for Hepatitis B?

Novel therapies include:

• Gene editing (first-in-human HBV trial approved in 2025)
• Capsid assembly inhibitors like bersacapavir
• Monoclonal & antisense drugs: e.g., lenvervimab, Bepirovirsen

Complications & Prognosis

Rare but serious hepatitis B complications include:

• Cirrhosis: scar tissue forms, causing liver dysfunction
• Hepatocellular carcinoma: liver cancer risk increased
• Encephalopathy: brain function compromised in end-stage disease
• Co-infection risks: With hepatitis D, if HBV is already present

Early detection and antiviral suppression are proven to lower these risks significantly.

Prevention & Screening of Hepatitis B

• Universal hepatitis B immunization in the UAE has reached ~98% coverage of the population, especially infants and  children
• Still, 70% of cases go undiagnosed
• Early screening of high-risk groups (health workers, pregnant women, travelers, families of HBV carriers) helps prevent the spread
• Avoid sharing needles, and practice safe sex, vital hepatitis B precautions

Conclusion

• Hepatitis B disease is preventable, diagnosable, and treatable.
• Timely action through vaccination, regular diagnosis (blood tests), and modern antivirals can turn HBV into a controlled condition.
• Cutting-edge research gives hope for a cure in the near future.
• Family screening and stigma reduction are key; talk to your loved ones and your doctor to understand the dimensions of the situation and follow their instructions carefully.