Symptoms and Complications

Symptoms and Complications

Many people with Hepatitis B do not have symptoms until they develop advanced liver disease.

If symptoms occur, it may include: fatigue tends to predominate over other constitutional symptoms, such as poor appetite, malaise, abdominal pain and yellow skin and eyes (jaundice).

Complications of hepatitis B includes cirrhosis which is associated with decreased survival and an increased frequency of HCC. 84% 5-year survival rate was reported for patients with compensated HBV-related cirrhosis, compared with 14% for patients with cirrhosis complicated by ascites, jaundice, encephalopathy, or a history of variceal bleeding.

Other complications are liver decompensation and HCC. The estimated annual frequency of developing hepatic decompensation in HBV-associated cirrhosis is 5% to 8%, whereas that of HCC is
2% to 4%.

Factors associated with an increased risk of HCC include male gender, age 45 years or greater, having a first degree relative with HCC, the presence of cirrhosis, HBeAg positivity, reversion from anti-HBe to HBeAg positivity, and increased HBV DNA levels regardless of the HBeAg state.

In addition, HCC can occur in cirrhotic patients who have undergone HBsAg seroconversion, and all patients with cirrhosis need continued surveillance.