Hepatitis B
Introduction
Hepatitis B is a vaccine-preventable liver infection caused by the hepatitis B virus. It is spread by contact with bodily fluids through sex, IV drug use, or from mother to baby at birth. Hepatitis B infections can be either acute (short-term) or chronic (long-term).
Most healthy people recover from acute hepatitis B without treatment, but acute hepatitis B can sometimes lead to life-long infection known as chronic hepatitis B. Infants and young children are most likely to develop chronic hepatitis B if infected.1 About 15 to 25 percent of people with chronic infection will develop chronic liver disease, including cirrhosis, cancer, or liver failure.
Currently, there is no treatment available for acute cases of hepatitis B, but people with chronic hepatitis B infections may be prescribed medication if symptoms are severe.
Vaccination remains the best method of preventing hepatitis B infections.
Acute Hepatitis B
Acute hepatitis B is a short-term illness that occurs within six months after exposure. Symptoms can include fatigue, poor appetite, stomach pain, nausea, and jaundice, but not everyone experiences symptoms. Up to half of older children and adults will have symptoms when newly infected with hepatitis B, and most children under five have no symptoms.2
Because many people with acute hepatitis B do not experience symptoms, the CDC estimates that the true number of cases is much higher than reported. In 2023, the CDC said that there were 2,214 reported cases of acute hepatitis B, but an estimated 14,400 infections nationwide.3
In 2024, Allegheny County had six reported cases of acute hepatitis B.
Chronic Hepatitis B
Almost all healthy adults clear an acute HBV infection with no lasting effects; however, 90% of infants with perinatal hepatitis B develop a chronic hepatitis B infection.1 Chronic hepatitis B is a life-long infection that can cause serious health problems, including liver damage, cirrhosis, liver cancer, and death.
In 2024, there were 30 confirmed* cases and 118 probable** cases of newly diagnosed chronic hepatitis B reported in Allegheny County (Figure 1).
*A confirmed case of chronic hepatitis B is defined as:
- Two positive HBsAg results at least 6 months apart, OR
- Two positive HBeAg results at least 6 months apart, OR
- Positive HBsAg or HBeAg AND positive total anti-HBc, OR
- Positive HBsAg AND HBeAg, OR
- Positive HBV DNA4
**Probable cases of hepatitis B are not nationally notifiable but are included in this report in line with PADOH’s annual report. A probable case of chronic hepatitis B is defined as a person with a positive HBsAg or HBeAg AND IgM anti-HBc is negative or unknown.4
Figure 1: Newly reported confirmed* and probable** chronic hepatitis B infections by year, Allegheny County 2014 to 2024
Of the 154 confirmed and probable cases in 2024, 65 (42%) were females, and 88 (57%) were males, and one was unknown. The 30 to 39 and 40 to 49 year-old age groups had the most cases reported (Figure 2).
Figure 2: Newly reported confirmed and probable* chronic hepatitis B infections by age group and sex, Allegheny County, 2024
Perinatal Hepatitis B
Hepatitis B infection can pass from mother to infant at birth, but transmission can be prevented by providing hepatitis B immune globulin and hepatitis B vaccine to infants within 12 hours of birth. According to the World Health Organization, without intervention, approximately 70 to 90 percent of infants born to infected mothers with high viral loads (or are HBeAg positive) will be infected with hepatitis B.5
In 2024, there were 21 infants born to mothers with chronic hepatitis B infections in Allegheny County. Of these infants, all 21 received hepatitis B immune globulin and hepatitis B vaccine. To date, no infant developed a hepatitis B infection.
Hospitalizations Associated with Hepatitis B
Depending on the severity of symptoms, hepatitis B infections may lead to hospitalization. Most people who have hepatitis B go to the hospital for other ailments, which may be complicated by their hepatitis B infection. In 2024, 184 people in Allegheny County were hospitalized with a primary or secondary diagnosis of hepatitis B. Of these, 178 (96%) had chronic or unspecified hepatitis B, and 6 (<1%) had acute hepatitis B (Figure 3).
Figure 3: Hepatitis B-related hospitalizations, Allegheny County residents, 2016 to 2024
Data source: Pennsylvania Health Care Cost Containment Council
In 2024, the median age for females hospitalized with a diagnosis of hepatitis B was 60 years, with a range 22 to 92 years, compared to a median age of 62 years for hospitalized males, with a range of 26 to 90 years (Figure 4).
Figure 4: Hepatitis B-related hospitalizations by age group and sex, Allegheny County, 2024
Data source: Pennsylvania Health Care Cost Containment Council
Deaths Associated with Hepatitis B
From 2022 through 2024, a total of 9 people in Allegheny County had hepatitis B listed as an underlying or contributing cause on their death certificate. Deaths associated with hepatitis B have decreased since the 2010 to 2012 time-frame (Figure 5).
Figure 5: Number of cases with hepatitis B listed as a cause of death, 2010 to 2024
Data source: CDC Wonder6
Prevention
The best way to prevent Hepatitis B is to get vaccinated. CDC recommends that all infants and adults under 60 get vaccinated against hepatitis B. If you haven’t been vaccinated, or if you’re unsure if you have been vaccinated, talk with your doctor or visit ACHD’s Immunization Clinic.
CDC also recommends all people over 18 years old get tested for hepatitis B at least once in their lifetime.
Other ways to prevent hepatitis B:
- Never share needles
- People who use intravenous drugs are at high risk of getting infected with hepatitis if they share needles or other equipment
- Avoid direct exposure to blood or blood products
- Any tools that encounter blood or draw blood should be disposed of safely or sterilized
- Don’t share personal care items
- Sharing razors or toothbrushes can also be a vehicle for viral transmission since small cuts sometimes occur on the skin or gums during use
- Avoid getting a tattoo or piercing
- If getting a tattoo or piercing, ask the artist about their sanitary procedures, such as using new disposable needles and ink wells for each customer and properly using an autoclave for non-disposable supplies.
- Practice safe sex
- Learn how to practice safe sex and avoid sexually-transmitted infections by visiting CDC’s website.
Resources
References
- Centers for Disease Control and Prevention. Clinical overview of Hepatitis B. August 2025.
- Centers for Disease Control and Prevention. Symptoms of Hepatitis B. January 2024.
- Centers for Disease Control and Prevention. Hepatitis B Surveillance 2023. April 2025.
- Centers for Disease Control and Prevention. Hepatitis B, acute and chronic 2024 Case Definition.
- World Health Organization. Hepatitis: Preventing mother-to-child transmission of the hepatitis B virus. July 2020.
- Centers for Disease Control and Prevention. CDC Wonder. October 2024.