What are the symptoms of Hepatitis B?

Hepatitis B infection does not cause symptoms in about 50% of the infected cases. These people may never realize that they have been infected. Symptoms after infection are more likely to occur in adults rather than children. Those who show signs and symptoms usually do so within 1 to 4 months after exposure to the virus. The initial symptoms are non-specific and often similar to flu.

Some common symptoms of hepatitis B are:

• Loss of appetite.
• Feeling tired (fatigue) or exhausted.
• Nausea and vomiting.
• Itching or irritation all over the body.
• Pain in abdomen (at a spot located over the liver towards  the right side of the abdomen, and under the lower rib cage).
• Jaundice (yellowish discolouration of skin and the whites of the eyes).
• Dark coloured urine (the colour of cola or tea).
• Pale stools (greyish or clay coloured).

Other causes of liver infection such as acute viral hepatitis due to hepatitis A and hepatitis C have symptoms that are identical to those of hepatitis B.

Fulminate hepatitis: Some people with hepatitis B infection develop a severe form of acute hepatitis that can be life-threatening if not treated without delay. This type of hepatitis is known as fulminate hepatitis and it is fortunately rare. Symptoms of fulminate hepatitis develop very abruptly and progress rapidly. They may include:

• Mental changes such as confusion, lethargy, extreme sleepiness, stupor or hallucinations (hepatic encephalopathy).
• Sudden collapse or loss of consciousness.
• Jaundice.
• Swelling of the abdomen (due to collection of fluid in the abdomen).
• Severe nausea and vomiting.

Severe nausea and vomiting can lead to dehydration. Some symptoms which may be observed in a person with dehydration are:

• Extreme weakness or fatigue.
• Confusion or difficulty in concentrating.
• Headache.
• Lack of urination.
• Irritability.
• Feeling very thirsty.

Hepatitis B infection can cause liver damage. Some symptoms of liver damage include:

• Ascites—Fluid retention in the abdomen (it causes swelling of the abdomen). Some people may develop swelling of legs as well.
• Increase in body weight due to ascites.
• Persistent jaundice.
• Loss of appetite, weight loss, wasting.
• Blood in vomiting.
• Bleeding from the nose, mouth, or rectum; or blood in the stool.
• Delay in clotting of blood.

Severe damage to the liver can cause hepatic encephalopathy. Symptoms of hepatic encephalopathy include excessive sleepiness, mental confusion, and in advanced stages, coma.