Hepatitis B

Symptoms

In acute infection:

• Tiredness, loss of appetite, nausea
• Pain in the upper right abdomen
• Jaundice, dark urine, pale stools
• Fever, joint pain

Many people have no symptoms. Chronic infection can stay silent for years. Having no symptoms does not mean there is no infection.

Diagnosis

The diagnosis is made with serological tests. A triple panel is recommended:

• HBsAg: active infection (acute or chronic)
• Anti-HBs: immunity (vaccine or past infection)
• Total anti-HBc: past or ongoing infection

If HBsAg is positive, chronicity and activity are assessed with HBV DNA and liver enzymes. HBsAg screening is recommended in the first trimester of every pregnancy. If there is risk or no vaccination history, the triple panel may be done. Other STIs (HIV, syphilis, hepatitis C) should be assessed at the same time.

Treatment and vaccination

Acute hepatitis B usually heals with supportive care. In chronic hepatitis B, antiviral treatment (tenofovir, entecavir) is planned according to indications. Treatment is not provided at the clinic; patients are referred to a gastroenterology or infectious diseases centre.

Vaccine:

• Three doses (months 0, 1 and 6) is the standard schedule
• Anti-HBs ≥ 10 mIU/mL is considered protective
• In risk groups, serology before vaccination is recommended
• The vaccine can be given in pregnancy

A baby born to an HBsAg-positive mother is given the vaccine and hepatitis B immunoglobulin (HBIG) within 12 hours of birth. Breastfeeding is generally safe.

Pregnancy

HBsAg screening is done routinely in pregnancy. If the result is positive, the viral load is assessed; with a high viral load, antiviral treatment late in pregnancy may be discussed to reduce mother-to-baby transmission. Prophylaxis for the baby after birth is planned. Management is shared between obstetrics and the relevant specialty.

Prevention

• Hepatitis B vaccine
• Using condoms
• Avoiding shared needles and sharp instruments
• Screening in pregnancy
• Partner and family screening (if positive)

In vaccinated people who are anti-HBs positive, an extra dose is usually not needed. If the risk continues, anti-HBs levels can be monitored.

Our approach at SoftCare

At SoftCare Clinic, hepatitis B assessment begins with a gynaecological history and risk assessment. HBsAg or the triple panel is run at a partner laboratory. If the result is positive, a referral to gastroenterology or infectious diseases is made. If there is no vaccination history and no immunity, a vaccination plan is discussed. If there is a pregnancy, HBsAg screening and, if needed, further assessment are done. Tests for HIV and other STIs can be planned at the same time. Treatment of chronic hepatitis B is not provided at the clinic.

Appointments: +90 212 241 30 10 · softcareclinic.com

References

• 1. Centers for Disease Control and Prevention (CDC). Hepatitis B. Clinical Overview and Screening Recommendations (2023 update).
• 2. Centers for Disease Control and Prevention (CDC). Clinical Overview of Perinatal Hepatitis B.
• 3. World Health Organization (WHO). Hepatitis B. Fact sheet.
• 4. T.C. Sağlık Bakanlığı (Ministry of Health of Türkiye). Hepatit B aşı programı ve risk grupları (hepatitis B vaccination programme and risk groups).
• 5. U.S. Preventive Services Task Force (USPSTF). Screening for Hepatitis B Virus Infection in Adolescents and Adults.
• 6. American College of Obstetricians and Gynecologists (ACOG). Hepatitis B in Pregnancy.
• 7. Merck Manual Professional Edition. Hepatitis B.
• Note: The screening panel, vaccine schedule and management in pregnancy are updated by the physician according to current national and international guidelines. This reference list is for information only.

Listing a source does not mean SoftCare wrote that text.

Medically reviewed by Op. Dr. Şükrü Sanus, Obstetrician & Gynecologist · Last medical review: 2 October 2026