If you or someone close to you has hepatitis B, you might have questions about the overall outlook. Here’s what you should know.

Hepatitis B is an infection of the liver. Most of the time, it’s acute and will resolve without any treatment required. However, it can be chronic, and there’s currently no cure.

It causes infection and inflammation of the liver and can be passed from parent to child during birth or when a bodily fluid, like blood or semen, from a person with the virus enters somebody else who doesn’t have it.

The condition isn’t typically fatal, and in most people will cause no permanent damage. But in some people, chronic hepatitis B infection can lead to liver cancer or cirrhosis, which can be fatal.

It’s difficult to know exactly how many people have hepatitis B in a given year. Many people who have an acute hepatitis B infection only — those who do not develop chronic hepatitis B — may not report having the condition.

In fact, according to the Hepatitis B Foundation, only 25% of people who have hepatitis B receive a diagnosis.

Not only that, but getting the most accurate global figures will be difficult as some areas are more remote, or make collecting this sort of data more difficult logistically.

The World Health Organization estimates that, in 2019, 296 million people were living with chronic hepatitis B, with 1.5 million new infections each year. And that same year, hepatitis B resulted in approximately 820,000 deaths, largely from liver cancer and cirrhosis.

In the United States, up to 2.4 million people have chronic hepatitis B infections. However, from 2013 to 2019, there was progress in reducing hepatitis B-related deaths.

The age-adjusted hepatitis B-related mortality rate decreased from 0.46 deaths per 100,000 people in 2017 to 0.42 in 2019, below the target rate of 0.43. To meet the target of 0.25 deaths by 2025, an 11.9% reduction from the 2019 figures is needed.

In the earliest stages of hepatitis B, up to half of people age 5 or over will show symptoms. However, those under 5 and adults with a suppressed immune system may not.

Acute symptoms are likely to appear around 60–150 days after exposure to the virus, and they might last from a few weeks to a few months.

When early symptoms do appear, they might include the following:

Around 25% of chronic hepatitis B infections will progress into liver cancer, while cirrhosis can also develop.

Many hepatitis B infections occur in infancy or early childhood because a parent has transmitted the virus to the child during birth.

However, it’s not always diagnosed in childhood because of the lack of symptoms. Around 95% of infants with hepatitis B go on to develop a chronic infection.

In comparison, fewer than 5% of adults develop a chronic infection. Most adults with hepatitis B will experience little or no symptoms, and the infection won’t last for longer than a few months.

Between 2011 and 2019, rates of hepatitis B were low among children and adults under 30, largely due to the vaccine. But in the same period, rates of hepatitis B increased among people ages between 40 and 60.

An acute hepatitis B infection will often resolve on its own, with no lasting effects and full recovery.

While chronic infections can be treated with antiviral medication, there’s no cure. Chronic hepatitis B can lead to permanent liver damage, and a liver transplant may be required to increase the chance of long-term survival.

With chronic hepatitis B, there’s a chance of cirrhosis or liver cancer developing quite rapidly. Without adequate treatment, liver cancer can be fatal within months.

The hepatitis B vaccine offers over 98% protection against the virus. It’s thought that the vaccine will prevent 38 million deaths over the lifetime of people born between 2000 and 2030 in low- and middle-income countries.

With chronic hepatitis B, ongoing evaluation and monitoring are important. People living with chronic hepatitis B need an ultrasound of the liver every 6 to 12 months.

People who have hepatitis B may be more likely to develop certain cancers, including:

The following may increase the risk of death among people who have chronic hepatitis B:

There are also links between increased mortality and barriers to care, particularly among at-risk populations.

Research has found differences in mortality rates when factors like birthplace are taken into account. For example, the average age at death of those with hepatitis B-listed deaths was lowest in the Appalachian states.

Hepatitis B can be difficult to deal with, but you aren’t alone.

The Hepatitis B Foundation is a U.S.-based nonprofit focusing on finding a cure for hepatitis B and improving the quality of life of those living with the condition. They provide both support and more information for anybody affected.

The American Liver Foundation also provides information on the condition, as well as support. You can call their helpline at 1-800-465-4837 or send an email via the ”ask a question” feature on the website.

Your doctor may also be able to help direct you toward local resources or support.

Adam England lives in the UK, and his work has appeared in a number of national and international publications. When he’s not working, he’s probably listening to live music.