Search

Chronic Hepatitis B

Infectious Disease

FibonacciCOMPENDIUM

InBrief

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.


Diagnostic Evaluation

hepatitis b virus

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...


Read the conclusion on FibonacciMD.app

more about:

  • Causes and Risk Factors

  • Staging (there are four phases of chronic HBV infection)

  • Treatment of Hepatitis B

  • Prevention of Hepatitis B

Read the full Chronic Hepatitis B InBrief on www.FionacciMD.app

 

FibonacciMD.app members can get access to the PDF, non-members can pay $1.00 for the PDF.

For more information Hepatitis B check out our FibonacciCOMPENDIUM on FibonacciMD.app

Not an APP member? Membership info.

#InBrief #InfectiousDisease

 

References:


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.




DISCLAIMER


IMIT takes pride in its work, and the information published on the IMIT Platform is believed to be accurate and reliable. The IMIT Platform is provided strictly for informational purposes, and IMIT recommends that any medical, diagnostic, or other advice be obtained from a medical professional. Read full disclaimer.