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Swelling
Joint pain that is always there
Liver failure
Loss of appetite
Bloating
Yellow eyes
Edema
Not seeing your symptoms? No worries!
Inflammation of the liver and/or liver enzyme abnormalities that lasts for more than six months. Consequences of chronic hepatitis may include scarring or cirrhosis and its complications, liver failure, liver cancer, or bleeding disorders. It is often caused by viruses like hepatitis B and C. Other causes include chronic alcohol use, fatty liver disease, and autoimmune diseases (body's immune system attacking itself).
Your doctor may ask these questions to check for this disease:
Treatment depends on the cause of hepatitis. Some causes are treated with antiviral medicines, while others require immune-suppressing medications. Regular medical follow-up is advised to monitor.
Reviewed By:
Samantha Nazareth, MD (Gastroenterology)
Board-certified gastroenterologist. Experience managing gastrointestinal conditions (GERD, IBS, ulcerative colitis, Crohn’s, celiac disease, NASH) within healthcare organizations (three ambulatory surgical centers, single-specialty practice, multi-specialty practice and solo practice).
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Mar 27, 2025
Following the Medical Content Editorial Policy
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Q.
Drained? Why Hepatitis B Is Your Liver’s Silent Fire + Medical Next Steps
A.
Feeling drained or foggy? Hepatitis B is a silent liver infection that can smolder for years and cause fatigue, yet it is preventable, detectable, and treatable through vaccination, targeted blood tests, monitoring, and when needed antivirals. There are several factors to consider; see below for who is at risk, the exact tests to request, when treatment is recommended, how to protect loved ones, and urgent warning signs, as these details can shape your next medical steps.
References:
* Kim B, Lim YS. Update on Hepatitis B Virus Infection: Pathogenesis, Diagnosis, and Treatment. Gut Liver. 2023 Mar 15;17(2):206-218. doi: 10.5009/gnl22045. Epub 2022 May 25. PMID: 35619379.
* Sagnelli E, Sagnelli C, Sagnelli C, Sagnelli E, Coppola N, Pascarella S, Sagnelli E. Current and Future Therapeutic Strategies for Chronic Hepatitis B. Viruses. 2023 Feb 1;15(2):409. doi: 10.3390/v15020409. PMID: 36851608.
* European Association for the Study of the Liver. Guidance for the treatment of chronic hepatitis B: an update for 2023. Lancet Gastroenterol Hepatol. 2023 Aug;8(8):722-736. doi: 10.1016/S2468-1253(23)00155-2. PMID: 37402633.
* Locarnini S, Gish RG. Hepatitis B virus: from infection to global eradication. J Gastroenterol Hepatol. 2023 Sep;38 Suppl 2:S3-S10. doi: 10.1111/jgh.16279. PMID: 37575308.
* Papatheodoridis GV, Buti M, Goulis I, Janssen HLA, Lampertico P, Manolakopoulos S, et al. Natural History of Chronic Hepatitis B Virus Infection. Clin Liver Dis. 2018 Aug;22(3):525-546. doi: 10.1016/j.cld.2018.03.007. PMID: 30047366.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Batts KP, Ludwig J. Chronic hepatitis. An update on terminology and reporting. Am J Surg Pathol. 1995 Dec;19(12):1409-17. doi: 10.1097/00000478-199512000-00007. PMID: 7503362.
https://journals.lww.com/ajsp/Abstract/1995/12000/An_Update_on_Terminology_and_Reporting.7.aspxCobb BR, Valsamakis A. Chronic Hepatitis B, C, and D. Microbiol Spectr. 2016 Aug;4(4). doi: 10.1128/microbiolspec.DMIH2-0025-2015. PMID: 27726758.
https://journals.asm.org/doi/10.1128/microbiolspec.DMIH2-0025-2015American College of Gastroenterology
https://gi.org/topics/viral-hepatitis/