Chronic Hepatitis B

Infectious Disease



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

more about:

  • 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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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 › hepatitis › global

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