Chronic Hepatitis-B

Hepatitis B is a virus affecting the liver and can lead to acute and chronic hepatitis
Hepatitis B infection can be treated effectively with the available new antiviral medications
Untreated Hepatitis B can lead to liver cancer/cirrhosis and liver failure
Family members of the patients should be screened for Hepatitis B infection

Transmission routes and risks

  • Vertically, between a mother with chronic infection and her baby
  • Close person-to-person contact, usually in childhood (through open cuts or sores)
  • Sexually from male to female or vice versa
  • Parenteral route, transfusion of contaminated blood products
  • Sharing of needle amongst drug abusers

Risk factors

  • Household contacts of people who are HBsAg positive
  • Intravenous drug abuse
  • Contaminated blood products transmission
  • Contaminated surgical equipment usage
  • Tattoos
  • Haemodialysis.
  • Hepatitis B virus can lead to both acute and chronic hepatitis
  • Acute hepatitis is sudden onset severe inflammation of the liver

Symptoms

  • Usual symptoms are fever, bodyache, nausea and vomiting followed by jaundice
  • Liver function test usually reveals increased bilirubin, markedly elevated SGOT/SGPT.
  • HBsAg and IgM anti HBc are positive
  • Acute hepatitis is mostly self limiting, and body clears the virus in more than 90% of cases, however 5 % of patients may develop chronic hepatitis
  • 1 % of patients may develop features of liver failure and may requires ICU admission and liver transplantation
    Chronic hepatitis B is characterized by low grade inflammation of the liver, which manifest as tiredness, and slightly elevated liver enzymes
  • Four stages of Chronic hepatitis B are immune tolerance phase, immune clearance, immune control and state of immune escape
  • 30 % of patients with chronic hepatitis B are at risk for cirrhosis and liver cancer
  • Treatment strategy is to identify the patients who are at high risk for progressive liver disease and treating these patients with potent antiviral agents

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