Not everyone who is infected with HBV will experience symptoms of acute hepatitis—between 30 and 40 percent of people infected with the virus do not experience any noticeable symptoms. If symptoms do occur, they usually do so within four to six weeks after being infected and can last anywhere from one or two weeks to several months.
The symptoms of acute hepatitis B can include:
- Yellowing of the skin, whites of the eyes, and under the fingernails (jaundice)
- Dark urine and/or pale stool
- Feeling tired and rundown (fatigue)
- Abdominal pain
- Loss of appetite
- Joint pain
If the immune system is not able to control acute HBV infection within six months, symptoms of chronic hepatitis B are possible. Not everyone with chronic hepatitis B experiences symptoms. Some people with chronic hepatitis B experience occasional symptoms, while others experience symptoms that never seem to go away.
Symptoms of chronic hepatitis B can include those typically seen in acute hepatitis B. They tend to be mild to moderate in intensity and typically come and go. Other symptoms can occur, particularly in people who have been dealing with chronic hepatitis B for many years. Additional symptoms include rash, hives (urticaria), arthritis and burning/tingling in the arms and legs (polyneuropathy).
Less than 1 percent of people infected with HBV may experience a quick and severe (fulminant) infection, which, very rarely, can lead to liver failure and death. Symptoms of hepatitis, whether acute or chronic, should always be brought to the attention of a health care provider.
About 15 percent of adults who develop chronic hepatitis B—along with 25 percent of children who remain chronically infected with HBV—die prematurely from cirrhosis (scarring of the liver) or liver cancer. In the United States, chronic HBV infection results in an estimated 2,000 to 4,000 deaths per year.