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HBsAg ( hepatitis B surface antigen) is the first immunological marker of hepatitis B viral infection. Most people do not experience any symptoms when newly infected. However, some people have acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. People with acute hepatitis can develop acute liver failure, which can lead to death. Among the long-term complications of HBV infections, a subset of persons develops advanced liver diseases such as cirrhosis and hepatocellular carcinoma, which cause high morbidity and mortality.