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