Which statement is true about chronic hepatitis B?

• A. It is always symptomless
• B. Everyone with hepatitis B develops chronic infection
• C. A small number can develop chronic hepatitis B leading to liver scarring
• D. It cannot be prevented by vaccination

Answer: (C)

Chronic hepatitis B occurs when the body does not clear the hepatitis B virus and the infection persists for a long time, typically defined as more than 6 months. Most adults recover from the initial acute infection, but a small proportion stay infected and become chronically infected. This chronic state can drive ongoing liver inflammation that over time leads to liver scarring (fibrosis) and can progress to cirrhosis or liver cancer. Vaccination prevents HBV infection in the first place, so it also prevents chronic infection. Therefore, the statement that a small number can develop chronic hepatitis B leading to liver scarring is true. The idea that it is always symptomless is incorrect, and not everyone exposed becomes chronically infected, and vaccination can prevent infection.