Hepatitis B

At a glance

  • Hepatitis B is the medical term for inflammation of the liver.
  • It is caused by infection with the hepatitis B virus.
  • Hepatitis B usually goes away on its own without causing any harm and doesn’t need to be treated.
  • But it can become chronic in some people and lead to liver damage.
  • There is a vaccine for hepatitis B. It is recommended for all babies and young children, as well as for adults who have a high risk of infection.


Photo of two men on a sofa

Hepatitis is the medical term for an of the liver. It is often caused by an with certain viruses. There are several types of hepatitis viruses, which are named using different letters: Hepatitis A, B, C, D and E.

The hepatitis B is mainly spread through blood, but also through other body fluids. It is rare for people to become infected with hepatitis B in countries like Germany. In adults, hepatitis B usually goes away on its own and doesn’t have any long-term effects. Many people don’t even notice that they have it. But it can sometimes become chronic and eventually lead to serious health problems.


Hepatitis B can cause various symptoms, including a lack of appetite, nausea and vomiting, yellowish skin and eyes (jaundice), generally feeling unwell, achy joints and fever.

Many people who become infected don’t have any symptoms, or they don’t have typical symptoms. And it can take 1 to 6 months for symptoms to occur after becoming infected. So a person may have hepatitis B for quite a while before it's diagnosed, and could unknowingly pass the on to other people during that time.

Risk factors

The is usually spread through unprotected sex (without using a condom) – most commonly between men who have sex with each other. People who have different sexual partners have a higher risk of getting hepatitis B. Other routes of include using non-sterile syringes when consuming drugs or having a tattoo done with non-sterile needles. The risk of is also higher for people who live with someone who has hepatitis B, and for people who permanently live in a country with a high number of infected people.

If a pregnant woman has hepatitis B, she might pass it on to her baby while giving birth. In Germany and other countries, pregnant women are offered a hepatitis B test. If a woman is found to be infected with the , measures can be taken to prevent her baby from becoming infected during or after the birth.


Fewer than 1 out of 100 people have hepatitis B in Germany. According to data collected by the Robert Koch Institute, about 6,800 people were infected with the hepatitis B in Germany in 2020.


Hepatitis B infections can lead to in the liver. Acute infections in adults usually clear up on their own and don’t have to be treated. In very rare cases they can lead to sudden liver failure.

If someone has had hepatitis B in the past and recovered from it, it means that their has made antibodies that will most likely keep the under control. In rare cases hepatitis B viruses can become active again – for instance, if the is very weak due to chemotherapy.

In some people the becomes permanent. Over time, chronic hepatitis B can lead to serious complications such as liver cirrhosis, a build-up of fluid in the abdomen (ascites), bleeding and liver cancer.

If a baby gets hepatitis B from their mother during or after their birth, the usually becomes chronic. This happens in 90 out of 100 children in this situation.


Hepatitis B can be diagnosed using a blood test to detect certain parts of the (such as antigens) or antibodies to parts of the .

The blood test can also be used to screen for hepatitis B – in other words, to detect hepatitis B in people who don’t have any symptoms yet.

Statutory health insurers in Germany cover the costs of being tested once for the hepatitis B for people aged 35 and over as part of a general check-up.

In Germany, pregnant women can be tested for hepatitis B for free – statutory health insurers pay for it as part of their standard prenatal care.


There is a vaccine for the prevention of hepatitis B. The German Standing Committee on Vaccination (STIKO) at the Robert Koch Institute (RKI) recommends that all babies and toddlers be vaccinated against hepatitis B. Whether or not the vaccine makes sense for adults will depend on their individual risk of , which depends on the risk factors mentioned above.

The vaccine is recommended if you

  • have a weakened ,
  • are planning to have medical treatment that suppresses the ,
  • are in close contact with people who have chronic hepatitis B, or
  • are more likely to be exposed to the at work (healthcare professionals or cleaning staff at a hospital).

It can be a good idea to have the vaccine before traveling to countries where hepatitis B is very common. You will find more information about travel vaccinations on the website of the World Health Organization.


In most cases the body’s is able to effectively fight a hepatitis B . Symptoms such as nausea and pain can be treated with suitable medication. Several months after hepatitis B is diagnosed, another blood test can be done to see whether any signs of the are still detectable. Sometimes small amounts of the remain in liver cells although there are no viruses in the blood. But the viruses in the liver cells rarely cause further problems.

Chronic hepatitis B infections are usually treated with tablets designed to fight the and prevent liver damage (nucleotide analogues / nucleoside analogues). Temporary treatment with interferon alpha may be considered too.

Cornberg M, Protzer U, Petersen J et al. Aktualisierung der S3-Leitlinie zur Prophylaxe, Diagnostik und Therapie der Hepatitis-B-Virusinfektion. AWMF-Register-Nr.: 021-011. 2021.

Institute for Quality and Efficiecy in Healthcare (IQWiG, Germany). Screening for hepatitis B: Final report; Commission S16-03. 2018.

Poethko-Müller C, Schmitz R. Impfstatus von Erwachsenen in Deutschland. Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsbl 2013; 56: 845–857.

Robert Koch-Institut (RKI). Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut 2022 (Epidemiologisches Bulletin 4/2022). 2022.

Robert Koch-Institut (RKI). Infektionsepidemiologisches Jahrbuch meldepflichtiger Krankheiten für 2020. 2021.

Robert Koch-Institut (RKI). RKI-Ratgeber: Hepatitis B und D. 2016.

Robert Koch-Institut (RKI). Virushepatitis B und D im Jahr 2020 (Epidemiologisches Bulletin 29/2021 ). 2021.

Trépo C, Chan HL, Lok A. Hepatitis B virus infection. Lancet 2014; 384(9959): 2053-2063.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on March 2, 2023

Next planned update: 2026


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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