It generally develops after an asymptomatic HBV infection. It is thought to occur when the body's immune system is unable to eliminate the virus. Chronic hepatitis B is most commonly detected in those who were infected in infancy or childhood and in adults who are unable to mount an effective cell-mediated immune response. The milder the initial infection, the greater the risk of developing a chronic carrier state.
Chronic carriers are highly infectious.
Chronic hepatitis B varies in severity from an asymptomatic disorder to an incapacitating disease. Chronic persistent hepatitis B This is the more common type. It is often asymptomatic and most chronic carriers do not seek medical attention for their condition. When symptoms are present, they may be relatively minor ones such as fatigue, abdominal pains, weakness, fever, and intolerance to fat or alcohol. The disease does not usually progress to severe liver disease but a few patients may develop chronic active hepatitis B. Chronic active hepatitis B Figure 3 - Cirrhosis of the liver Chronic active hepatitis B is more serious.