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 and other recommendations in treatment 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 (HBV)-related liver
disease are enumerated in the Prognosis
section while the effects of chronic HBV infection are mentioned
in the Complications section.
Frequently Asked Questions
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