• Many people with hepatitis B don't feel or look sick.

• You can still get liver disease even if you don't feel sick.

• You should get liver check-ups even if you feel ok. You will need to keep getting the check-ups to make sure your liver is ok.

Most people who get hepatitis B as adults get better in a few weeks or months. We call this acute hepatitis B. Some people feel like they are getting better, but the virus stays in their liver. These people have chronic hepatitis B. The younger you are when you get hepatitis B, the more likely you are to get chronic hepatitis B. Most people who have this form of hepatitis B got it from birth or when they were young children.

Signs of acute hepatitis B

Most infants and children do not show any signs that they have acute hepatitis B.

Among adults, about half will show signs of illness, such as:

• feeling less hungry
• muscle and joint pain
• low-grade fever
• stomach (belly) pain under the right lower ribs
• feeling sick in the stomach and vomiting
• yellowish eyes and skin (also known as jaundice) 

The signs might be very mild and may not last very long. If you do become sick or have any concerns, you should seek medical help straight away. This is because it can be life-threatening.

Signs of chronic hepatitis B

Chronic hepatitis B means you have hepatitis B that doesn't go away. It stays with you during your life. Many people with chronic hepatitis B don't have any signs of illness. When they do have signs, these could be the same as acute hepatitis B.

You might feel healthy if you have chronic hepatitis B, but it can still badly damage your liver. Some of the things that can happen to your liver over time are:

• liver scarring (we call this fibrosis). This means your liver becomes hard and does not work as well
• cirrhosis (severe liver scarring) from ongoing liver damage. This can lead to the liver not working well
• liver failure, which means your liver stops working
• liver cancer. You can get liver cancer even if you don't have any signs. This is more likely for certain people. Read more about who has a high risk of liver cancer. People who are in this ‘high risk’ category are offered a screening test every six months. The test is a painless ultrasound of the liver. You might also get an extra blood test. 

You are at higher risk of liver cancer if you:

• have cirrhosis
• have a family history of liver cancer
• are an Asian man over 40 years old
• are an Asian woman over 50 years old
• are Sub-Saharan African over 20 years old
• are Aboriginal or Torres Strait Islander over 50 years old

The only way to know if you have hepatitis B is to get a blood test through your doctor. Talk to your doctor if you have any signs of hepatitis B or think you could have it. There are lots of reasons you might need a test for hepatitis B, based on your background or past.

If you have hepatitis B, it is important to keep seeing your doctor to get your liver check-ups. You should do this even if you don’t have any signs of illness.

References

• B Positive: Hepatitis B for Primary Care, ASHM
• Hepatitis B, Better Health Channel, Victoria State Government Department of Health
• Overview of Chronic Hepatitis, MSD Manual