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Hepatitis B

Niyomi De Silva, MD, Heran Abiye, BS of Nutritional Sciences, MD and Afsha Rais, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

Infections caused by the hepatitis B virus (HBV), a DNA virus that is in the Hepadnaviridae family. HBV can lead to a spectrum of liver disease ranging from acute hepatitis to chroni...

DIAGNOSIS

HISTORY

  • Exposure: detailed family history, such as HBV infection and liver disease, and social history including alcohol use, drug use, and sexual history

  • Acute HBV

    • Fever, malaise, fatigue, art...

TREATMENT

GENERAL MEASURES

  • Vaccinate for HAV if seronegative.

  • Monitor CBC, coagulation, electrolytes, glucose, renal function, and phosphate.

  • Monitor ALT and HBV DNA; increased ALT and reduced DNA imply ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Serial ALT and HBV DNA:

    • High ALT + low HBV DNA associated with favorable response to therapy

  • CBC for WBC and platelets if on interferon therapy

  • Mon...

REFERENCES

1
Schillie S, Vellozzi C, Reingold A, et al. Prevention of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm ...

SEE ALSO

Cirrhosis of the Liver; Hepatitis A; Hepatitis C 

CODES

ICD10

  • B19.10 Unspecified viral hepatitis B without hepatic coma

  • B16.9 Acute hepatitis B w/o delta-agent and without hepatic coma

  • B18.1 Chronic viral hepatitis B without delta-agent

  • Z22.51 Carrier of...

CLINICAL PEARLS

  • Screen all patients born in countries with endemic disease for HBV infection using HBsAg.

  • Chronic HBV is present if HBsAg persists for more than 6 months. Patients with chronic HBV need...

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