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General Medicine

Hepatitis B

Afsha Rais Kaisani, FAAFP, MD, Tasaduq Hussain Mir, FAAFP, MD and Oregon J McDiarmid, M.D. Reviewed 04/2024
 


BASICS

DESCRIPTION

Hepatitis B infection (HBV), caused by a DNA virus, is often transmitted by body fluids (blood, semen and vaginal secretions). HBV is a serious global healthcare concern due to the s...

DIAGNOSIS

HISTORY

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

  • Acute HBV

    • Fever, ...

TREATMENT

GENERAL MEASURES

  • Vaccinate for HBV if seronegative.

  • Monitor CBC, coagulation, electrolytes, glucose, renal function. Monitor ALT and HBV DNA; increased ALT and reduced DNA imply response to th...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Serial ALT and HBV DNA: High ALT + low HBV DNA associated with favorable therapy response.

  • WBC and platelets if on interferon therapy

  • Monitor HBV ...

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 ...

ADDITIONAL READING

SEE ALSO

  • Cacoub P, Asselah T. Hepatitis B Virus Infection and Extra-Hepatic Manifestations: A Systemic Disease. J Gastroenterol. 2022;117(2):253-263. doi: ...

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 >6 months. Patients with chronic HBV need lifetime ...

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Related Images
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Chronic hepatitis with cirrhosis. A photomicrograph of the liver from a patient with long-standing chronic active hepatitis B shows hepatocellular nodules and chronically inflamed fibrous septa.

 

Chronic hepatitis with cirrhosis. A photomicrograph of the liver from a patient with long-standing chronic active hepatitis B shows hepato...

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