Chronic hepatitis B is a long-standing infection with the hepatitis B virus, a DNA virus of the Hepadnaviridae family that replicates in hepatocytes and is usually defined by viral presence beyond six months [1][2]. It represents the chronic stage of hepatitis B and carries an elevated risk of liver disease and hepatocellular carcinoma [1][2].
Disease overview
Evidence-backed information EN 5/7 applicable sections · ZH 5/7 applicable sections Updated Oct 23, 2026
Chronic hepatitis B is a persistent liver infection with the hepatitis B virus that follows acute exposure and is more likely when infection occurs at a younger age [1]. Most affected individuals remain without symptoms, though a substantial fraction progress to cirrhosis or liver cancer over time [1][2]. Public-health guidelines address its prevention and surveillance among specific risk groups [3].
Read the full clinical and epidemiological profile 6
Many persons with chronic infection are asymptomatic, yet the condition can progressively lead to liver cirrhosis, which independently raises hepatocellular carcinoma risk [1][2]. Complications such as liver decompensation or carcinoma affect survival, and concurrent hepatitis D infection may worsen disease course [2].
In assisted reproductive technology, sperm washing is not necessary for males with hepatitis B to prevent transmission, unless the female partner has not been effectively vaccinated [1]. In females with hepatitis B, the risk of transmission from mother to child with IVF is no different from the risk in spontaneous conception [1]. Those at high risk of infection should be tested as there is effective treatment for those who have the disease [1]. Screening is recommended for unvaccinated persons from areas where hepatitis B occurs in more than 2%, those with HIV, intravenous drug users, and men who have sex with men [1].
The virus spreads through contact with infectious blood or body fluids [1]. In regions where hepatitis B is common, acquisition typically occurs around birth or through childhood blood contact, whereas in low-prevalence settings intravenous drug use and sexual intercourse dominate [1]. Prevention efforts target maternal-to-infant and horizontal transmission routes [3].
Guideline development addressed prevention of maternal-to-infant and horizontal transmission of chronic hepatitis B using structured evidence review [3]. In assisted reproduction, sperm washing is not required for hepatitis B-positive males unless the female partner lacks effective vaccination, and mother-to-child risk via IVF equals that of spontaneous conception [1]. Screening is recommended for unvaccinated persons from high-prevalence areas, those with HIV, intravenous drug users, and men who have sex with men [1].
- 1 Wikipedia contributors. Hepatitis B - Wikipedia [Internet]. Wikipedia. cited 4 Sept 2026. Available from: https://en.wikipedia.org/wiki/Hepatitis_B
- 2 Rizzo GEM et al. Hepatitis B Virus-Associated Hepatocellular Carcinoma. Viruses. 2022 May 7. PMID: 35632728. doi: 10.3390/v14050986. PubMed: https://pubmed.ncbi.nlm.nih.gov/35632728/
- 3 Ghany MG et al. AASLD ISDA Practice Guideline on treatment of chronic hepatitis B. Hepatology. 2026 Apr 1. PMID: 41186418. doi: 10.1097/HEP.0000000000001549. PubMed: https://pubmed.ncbi.nlm.nih.gov/41186418/
- B18.0-B18.1
- 1E51.0
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