Chronic Hepatitis B
by Rich Strongwater, M.D.
Hepatitis B virus (HBV), a DNA virus, is the most common cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC) worldwide, leading to 0.5- to 1.2-million deaths/year. Approximately 70% of patients infected with HBV have subclinical or anicteric (without jaundice) hepatitis; some 30% develop acute icteric (with jaundice) hepatitis. After symptomatic acute infection, about 90% of infected neonates, 30%-50% of children 1-4 years of age, and 1%-10% (generally < 5%) of adults develop persistent infection. Approximately 15%-40% of patients with persistent infection develop advanced liver disease, cirrhosis, and/or HCC. Overall, > 2-billion persons worldwide have serologic evidence of HBV infection; of these, 300 million are chronic carriers with some form of chronic infection. In the U.S. there are an estimated 1.6 million residents with chronic hepatitis B infections. Foreign born U.S. residents (especially non-Hispanic Asians) have the highest prevalence. HBV infection is most prevalent in China, sub-Saharan Africa, and parts of the Middle East and Southeast Asia.
The incubation period for HBV infection generally lasts 1-4 months, but may last as long as 6 months. The hallmark of HBV infection is the presence of hepatitis-B surface antigen (HBsAg), the first serologic marker that typically appears 1-10 weeks after an acute exposure. Persistently elevated HBsAg levels after 6 months indicates a chronic infection.
Total Hepatitis-B core antibody (HBcAb or anti-HBc) and hepatitis-B IgM core antibody(IgM anti-HBc) b both appear shortly after the appearance of HBsAg. Anti-HBc may be...
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Causes and Risk Factors
Staging (there are four phases of chronic HBV infection)
Treatment of Hepatitis B
Prevention of Hepatitis B
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Johnson DF, Leder K, Torresi J. Hepatitis B and C infection in international travelers. J Travel Med. 2013;20:194-202.
Williamson MA, Snyder LA, eds. Wallach's Interpretation of Diagnostic Tests. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2011.
Fauci A, Braunwald E, Kasper D, et al. Harrison's Manual of Medicine. 17th ed. New York: McGraw-Hill Medical; 2009
Lim JK, Nguyen M, Kim W, Gish R, Perumalswami P, Jacobson I. Prevalence of Chronic Hepatitis B Virus Infection in the United States. The American Journal of Gastroenterology. 2020; 115,9:1429-1438. doi: 10.14309/ajg.0000000000000651
Heiberg IL, Hoegh M, Ladelund S, Niesters H, Hogh B. Hepatitis B Virus DNA in Saliva from Children with Chronic Hepatitis B Infection. Implications for Saliva as a Potential Mode of Horizontal Transmission. The Pediatric Infectious Disease Journal. 2010; 29,5:465-467. doi: 10.1097/INF.0b013e3181d8e009
Song JE, Kim DY. Diagnosis of Hepatitis B. Ann. Transl. Med. 2016;4(18):338. Doi. 10.21037/atm.2016.09.11
Global Viral Hepatitis: Millions of People are Affected | CDC Page last reviewed: July 19, 2021 Content source: Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention https://www.cdc.gov › hepatitis › global
Updated CDC Recommendations for the Management of Hepatitis B Virus–Infected Health-Care Providers and Students. MMWR Morbidity and Mortality Weekly Report. July 6, 2012. Retrieved from: https://www.cdc.gov/mmwr/pdf/rr/rr6103.pdf
[Table 1] Interpretation of Hepatitis B Serologic Test Results, CDC, 2005. Retrieved from: https://www.cdc.gov/hepatitis/hbv/pdfs/serologicchartv8.pdf.
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