Liver Diseases

Hepatitis B

Hepatitis B is an inflammatory liver disease caused by the hepatitis B virus (HBV). Mount Sinai Health System offers you the most advanced diagnostic procedures and treatments for hepatitis B. Our multidisciplinary team brings together physicians, nurses, dieticians, and psychologists to care for you.

As part of one of the nation’s premier Health Systems, our outstanding faculty, researchers, and clinicians collaborate to use the findings of the extensive research facilities at the Icahn School of Medicine at Mount Sinai. We also work with other organizations to bring you the latest medicines and apply what we learn in clinical trials to your treatment.

Additionally, our researchers are experts in molecular virology—studying viruses on a molecular level to understand how they affect the body. Our hepatitis B experts also conduct antiviral drug research and author papers published in peer-reviewed journals to share what we learn.

About Hepatitis B

Hepatitis B is an inflammatory liver disease caused by a virus (HBV). Acute hepatitis B occurs in the first months after you were infected,  and, in many cases, your body fights off the infection on its own. However, five to ten percent of cases progress to chronic liver disease. Chronic hepatitis B is an infection that lasts longer than six months. Once the infection becomes chronic, it may never go away completely. It can be very serious, leading to cirrhosis, liver cancer, liver failure, and death.

Knowing how to prevent and care for hepatitis B, your level of risk, how HBV is transmitted, and its symptoms can help you get the care you need to minimize its effects.

Preventing Hepatitis B

The best way to prevent infection from Hepatitis B is to get vaccinated. While you can get the vaccine at any age, the U.S. Advisory Committee on Immunization Practices recommends the hepatitis B vaccine for:

  • all infants starting at birth
  • adults aged 19-59 years
  • adults 60 years and older with risk factors for HBV, or if they ask for it

For full protection, you will need to complete a series of two to three injections. This vaccine provides long-lasting immunity. In most instances, the protection from the vaccine lasts a lifetime. Discuss with your doctor the value of the HBV vaccine for you and your loved ones. Currently, there is no cure for hepatitis B, and prevention is crucial. You can get the HBV vaccine at all Mount Sinai sites.

Risk Factors for Hepatitis B

Exposure to blood, semen, vaginal secretions, saliva, and other body fluids infected with hepatitis B virus (HBV) is the most common cause of transmission. Knowing this, if you discover that you touched an infected fluid, seek testing and care from a liver specialist immediately. Early detection and treatment may help you avoid the long-term effects of HBV.

People of all ages in the United States have a chance of developing chronic hepatitis B—even the youngest infants born to a mother with the virus who did not get treatment during pregnancy. Infected children often spread the virus to other children if there is frequent contact with an infected child or if a child has many scrapes and cuts.

In addition, risks for developing hepatitis B include:

  • Living with someone who has hepatitis B
  • Participating in high-risk activities, such as intravenous drug use or unprotected heterosexual or homosexual sexual contact
  • Receiving blood transfusions or blood products before the early 1990s
  • Working at a job that involves contact with human blood or body fluids

Symptoms of Hepatitis B

Not all HBV infections cause symptoms, but HBV can cause varied symptoms. If symptoms occur, they usually develop within one to six months of exposure to the virus. Flu-like symptoms are often misdiagnosed, and while your symptoms may be unique, the following are the most common symptoms of hepatitis B:

  • Appetite loss
  • Dark-colored urine
  • Fatigue
  • Itching all over the body
  • Jaundice (yellowing of the skin and the whites of your eyes)
  • Joint pain
  • Pain over the liver area
  • Nausea and vomiting
  • Skin rashes
  • Stools that are a pale grayish or clay color

Diagnosing Hepatitis B

Mount Sinai has pioneered one-time testing for HBV in all adults, in line with updated CDC guidelines, regardless of vaccination status. Additional testing is recommended during each pregnancy and annually in those at high risk of HBV infection, regardless of age.

Often, your doctor may discover hepatitis B when you get blood tests for another condition, during your annual check-up, as part of an insurance policy exam, or before surgery. If your doctor sees abnormalities in your liver blood test results, the next step may be a second blood test for liver function and hepatitis viruses. Routine blood tests do not always test for HBV, however, so be sure to ask your provider for HBV testing.

In addition to a complete physical examination and laboratory tests for blood and urine, diagnostic procedures for hepatitis B may involve an abdominal ultrasound, a CT scan, or an MRI to screen for liver cancer. A fibroscan (noninvasive imaging) can determine if there is scarring (fibrosis) on your liver and its extent.

Treatments We Offer

The Mount Sinai Health System offers you the most advanced diagnostic procedures and treatments for hepatitis B. Our multidisciplinary team brings together physicians, nurses, and care coordinators to care for you.

If you have a diagnosis of chronic hepatitis B, you should see your doctor regularly, with follow-up every three to six months. Depending on your diagnosis, treatment may include taking one pill daily to reduce the risk of long-term liver damage and cancer, and the risk of transmission to others.

Our primary goal of therapy for chronic hepatitis B is to suppress the hepatitis B virus. Treatment helps reduce inflammation, reverses the progression to cirrhosis and liver failure, and reduces your risk of liver cancer.

Mount Sinai’s Institute for Liver Medicine is part of one of the nation’s premier health systems. Our outstanding clinicians, faculty, researchers, and staff collaborate to use the findings of the extensive research facilities at the Icahn School of Medicine at Mount Sinai. We also work with other organizations to bring you the latest medicines and apply what we learn in clinical trials for the cure of HBV to your treatment.

Our researchers are experts in molecular virology—studying viruses on a molecular level to understand how they affect the body. Our hepatitis B experts also conduct antiviral drug research and author papers published in peer-reviewed journals to share what we learn.

Our Liver Education and Action Program (LEAP) team supports and coordinates the care of patients with chronic HBV—from diagnosis through treatment start, assisting with insurance and pharmacy coordination, appointment scheduling, and serving as a liaison between patients, their caretakers, and providers.

How Common Is Hepatitis B?

Hepatitis B represents a significant global health problem, with five percent of the world’s population infected by the virus. The World Health Organization (WHO) estimates that two billion people worldwide have been exposed to HBV. Among them, 296 million people have chronic infection. HBV is responsible for more than 800,000 deaths per year globally, and 75 percent of the people with chronic hepatitis B are in Asia. In Asia, 8-10 percent of the population is chronically infected, and up to 50 percent of new cases are due to mother-to-child transmission.

In the United States, fewer than 1 in 2,000 people have HBV, and the burden of chronic HBV infection is greater among certain populations. This is due to infection occurring at an early age and higher levels of the infection circulating in certain communities. Because official guidelines have recommended risk-based screening until very recently, there has been limited testing, and many infected people are not aware they have the virus. The New York City Department of Health and Mental Hygiene estimates that about 2.9 percent of NYC residents have chronic HBV and almost half are unaware of their diagnosis. WHO advises routinely screening everyone in settings where prevalence is 2 percent or higher.