Clinical Signs and Symptoms of Hepatitis B

Key points

  • People with acute hepatitis B virus (HBV) infection may have mild or no symptoms.
  • Most people with chronic HBV infection are asymptomatic.
  • The presence of signs and symptoms varies by age.
A man and a woman sitting in a doctor's office speaking with a medical professional

Disease presentation

Not all people with acute hepatitis B virus (HBV) infection have symptoms. Symptoms can range from asymptomatic or mild disease to, rarely, fulminant hepatitis. The presence of signs and symptoms varies by age. Infants and children under 5 years old with acute HBV infection are typically asymptomatic. People younger than 30 years old are less likely to be symptomatic compared with persons 30 years and older.

Most people with chronic HBV infection are asymptomatic and have no evidence of liver disease or injury. However, some people develop chronic hepatitis (elevation of aspartate aminotransferase [AST]/alanine aminotransferase [ALT]), cirrhosis, or hepatocellular carcinoma (i.e., primary liver cancer).

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Hepatitis B Symptoms

Common symptoms

When present, signs and symptoms for acute hepatitis B appear an average of 90 days after exposure, but range from 60–150 days12. Common symptoms of acute hepatitis B are:

  • Abdominal pain, nausea, and/or vomiting
  • Dark urine or clay-colored stools
  • Fatigue
  • Fever
  • Jaundice
  • Joint pain
  • Loss of appetite

Severity of symptoms

For many people, symptoms of acute hepatitis B infections last anywhere from 6 weeks up to 6 months.12 In some cases, the infection can progress to chronic hepatitis, primary liver cancer, or cirrhosis.

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Content Source:
Division of Viral Hepatitis
  1. Hoofnagle JH, Di Bisceglie AM. Serologic diagnosis of acute and chronic viral hepatitis. Semin Liver Dis. 1991;11(2):73–83.
  2. Krugman S, Overby LR, Mushahwar IK, Ling CM, Frosner GG, Deinhardt F. Viral hepatitis, type B. Studies on natural history and prevention re-examined. V. N Engl J Med. 1979;300(3):101–6.