Symptoms

Many people infected with viral hepatitis have no symptoms. For example, about one-third of people infected with HBV have a completely "silent" disease. When symptoms are present, they may be mild or severe. The most common early symptoms are:

• mild fever
• headache
• pain in muscles, joints or stomach
• fatigue
• loss of appetite
• nausea, vomiting, or diarrhoea.

Later symptoms may include:

• dark and foamy urine
• pale, chalky faeces
• abdominal pain
• yellowing of the skin and whites of the eyes (jaundice)

A patient with jaundice

About 15 to 20 percent of patients develop short-term arthritis-like problems as part of a more severe case of hepatitis. Another one-third of those with hepatitis B develop only mild flu-like symptoms without jaundice. Very severe (fulminant) hepatitis B is rare, but life threatening. Early signs of fulminant hepatitis, such as personality changes and agitated behaviour, require immediate medical attention.