Chronic Hepatitis B Phases
Chronic Hepatitis B Phases
When you are diagnosed with chronic hepatitis B it is very important that you see your doctor or liver specialist regularly for monitoring, usually every six months.
Hepatitis B can progress to cirrhosis (liver scarring), liver cancer and liver failure, so knowing what is happening in your liver is important for staying healthy and well.
Understanding the phases of hepatitis B and knowing what phase you are in will determine whether you need to consider treatment (antiviral therapy).
When reading this factsheet think of the hepatitis B bear as the bepatitis B virus. Also, remember that you might move between phases and not necessarily from phase 1 to phase 2 to phase 3.
Phase 1 – Silent
Your doctor or liver specialist might call it:
- Immune tolerance phase
What does this mean?
The hepatitis B bear is sleeping—the virus is not making you sick. Millions of copies of the virus are being made but no damage is being done to your liver.
Will I need to treat my hepatitis B?
No, but you should see your doctor or liver specialist regularly for monitoring, usually every six months.
What is happening in my liver?
- High viral load
- Normal LFT
Phase 2 – Damage
Your doctor or liver specialist might call it:
- Immune clearance phase
What does this mean?
The hepatitis B bear is attacking— your immune system is attacking the virus and trying to get rid of it. Your liver is being damaged in this phase.
Will I need to treat my hepatitis B?
Treatment (antiviral therapy) of hepatitis B may be required in this phase to prevent the virus from damaging your liver. However, sometimes the body can control the virus without treatment. Monitoring is very important during this phase and you may need a referral to a liver specialist.
What is happening in my liver?
- High viral load
- Abnormal LFT
Phase 3 – Control
Your doctor or liver specialist might call it:
- Immune control phase
What does this mean?
The hepatitis B bear is in a cage—your immune system has got the virus under control and no further damage is being done to your liver.
Will I need to treat my hepatitis B?
Treatment (antiviral therapy) of hepatitis B is not generally needed in this phase. However, monitoring is essential. Monitoring may include blood tests and ultrasounds to pick up any early signs of liver cancer.
What is happening in my liver?
- Low viral load
- Normal LFT
Phase 4 – Escape
Your doctor or liver specialist might call it:
- Immune escape phase
What does this mean?
The hepatitis B bear escapes from the cage—the virus is out of control and your liver is being damaged again, particularly if there was damage done in previous phases.
Will I need to treat my hepatitis B?
Treatment (antiviral therapy) may be required in this phase. Monitoring is important during this phase and you may need a referral to a liver specialist.
What is happening in my liver?
- High viral load
- Abnormal LFT
What are some of the common symptoms of hepatitis B?
Many people with hepatitis B do not experience any symptoms, particularly those with chronic (lifelong) hepatitis B. However, with an acute infection (less than six months) you may feel sick and experience symptoms as your immune system reacts to the virus.
Some of the symptoms can include nausea, tiredness, fever, dark urine, joint or stomach pain, jaundice (yellowing of the skin and eyes), or loss of appetite.
