When do the symptoms appear?

The incubation period of hepatitis B, i.e. the time between infection and the appearance of the first symptoms, is between 45 and 180 days. About 1/3 of those infected do not show any symptoms. In the other 2/3, flu-like symptoms occur on average after 60 to 120 days. One to two weeks later, jaundice may follow.

Liver Failure

In rare individual cases (approx. 1%) a life-threatening fulminant liver destruction with liver failure (see also Liver function) can occur, so that the affected person can often only be helped by a liver transplant.

Chronic Hepatitis B

In about 10% of cases, the virus persists (chronic course of hepatitis B infection), and the often unsuspecting patient often becomes an asymptomatic virus carrier (so-called excretor). One speaks of chronic hepatitis B if the symptoms and/or the corresponding viral markers persist for more than 6 months. The chronicity rate of infected persons increases with age and is particularly high in newborns (approx.

90%). This chronic infection of the liver sooner or later leads to liver cirrhosis (connective tissue remodelling of the liver/loss of liver function). In principle, chronic hepatitis B virus infections are associated with a significantly increased risk of developing hepatocellular carcinoma.

An already existing liver cirrhosis further increases this risk. An important co-factor in the development of liver cirrhosis and liver cancer is a simultaneous alcohol dependency (alcohol abuse) of the patient and a secondary infection with the hepatitis C and D virus. The chronic form of hepatitis B, like the acute form, is often asymptomatic.

However, symptoms can also occur. These possible symptoms include, for example, a feeling of pressure in the right upper abdomen, muscle, limb and joint pain as well as exhaustion and loss of appetite. One of the most important complications of chronic hepatitis B is the development of liver cirrhosis.

If such cirrhosis develops, it can be accompanied by numerous other symptoms. First, however, in most cases cirrhosis of the liver also proceeds asymptomatically. Only in advanced stages (Child-Pugh stages B and C) do symptoms such as water retention (edema), water belly (ascites) and signs of hepatitis such as spider naevi, vein markings on the skin, or palmarerythema, a flat redness on the inside of the hands, appear.

In advanced liver cirrhosis, many patients develop varicose veins in the area of the esophagus (esophageal varices). These are constantly increasing in size and may eventually burst and then lead to pronounced bleeding. Such bleeding can lead to haemorrhaging and circulatory instability, and rapid therapy is required. In advanced stages of liver cirrhosis, the increasing failure of the detoxification functions of the liver can lead to disturbances of consciousness; this is known as hepatic encephalopathy. Cirrhosis of the liver in an advanced stage means a significantly reduced life expectancy.