Hepatitis B Disease Summary

Last updated: 15 May 2025

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Overview

Hepatitis B infection is caused by a virus that belongs to the family of Hepadnaviridae of small, enveloped, primarily hepatotropic DNA viruses.  Hepatitis D requires hepatitis B infection for its replication. The disease caused by hepatitis D can be acute or chronic, a coinfection, or a superinfection. Definitions of these two types of hepatitis are further discussed in the Introduction section.

Hepatitis B affects 296 million people worldwide. It has an intermediate to high prevalence in Asia. A more detailed discussion on the prevalence of Hepatitis B can be found in the Epidemiology section.

The effects of infection with hepatitis B are discussed in the Pathophysiology section.

Phases of chronic hepatitis B are described in the Classification section. 

History and Physical Examination

Most acute viral hepatitis infections are asymptomatic, or they can cause an anicteric illness that may not be diagnosed as hepatitis. Specific signs and symptoms of the different types of hepatitis are in the Clinical Presentation section.

In patients suspected of having viral hepatitis, there are important points in the clinical history that should be elicited, and these are enumerated in the History section. In the Screening section, individuals who are recommended to have a screening for Hepatitis B infection are identified. 

Diagnosis

The Laboratory Tests and Ancillaries section enumerates and discusses the tests to be performed in confirming the diagnosis of hepatitis B.

The Differential Diagnosis section enumerates the viral and non-viral diseases that can be considered in patients suspected to have hepatitis B infection. 

Management

The Evaluation section discusses the tests to be done in determining the disease severity that is essential in identifying the appropriate management.

The main goal of treatment is to prevent the risk of hepatic failure in acute hepatitis B and to eradicate or achieve long-term suppression of both hepatitis B and D viruses in patients with hepatitis D. Other goals of treatment for specific types of hepatitis are discussed in the Principles of Therapy section.

The Pharmacological Therapy section enumerates the antivirals and other therapeutic options for the management of hepatitis B and D.  

Information to be relayed during patient education is discussed in detail in the Nonpharmacological section.

Indications for liver transplantation are mentioned in the Surgery section.

Patient groups for whom prevention and post-exposure prophylaxis of hepatitis B is recommended are listed in the Prevention section. Included also in this section are the recommended prevention or post-exposure prophylaxis regimens.

Goals in monitoring the patient’s response during and at end of treatment are discussed in the Monitoring section.

Predictors of progression of hepatitis B virus-related liver disease are enumerated in the Prognosis section while the effects of chronic hepatitis B virus infection are mentioned in the Complications section.