Chronic Hepatitis B

The virus of Hepatitis B affects the liver and can further lead to acute and chronic hepatitis. The Hepatitis B infected patients can be treated successfully with the help of new antiviral medications. Hepatitis B, if untreated, can further lead to liver cancer/cirrhosis and even liver failure. Patients family members must get checked for possible Hepatitis B infection.

Transmission routes and risks

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

Risk factors:

  1. Household contacts of people who are HBsAg positive
  2. Intravenous drug abuse
  3. Contaminated blood products transmission
  4. Contaminated surgical equipment usage
  5. Tattoos
  6. Haemodialysis

Hepatitis B virus can lead to both acute and chronic hepatitis

 

Acute hepatitis is sudden onset severe inflammation of the liver

  1. Usual symptoms are fever, bodyache, nausea and vomiting followed by jaundice
  2. Liver function test usually reveals increased bilirubin, markedly elevated SGOT/SGPT
  3. HBsAg and IgM anti HBc are positive
  4. 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
  5. 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 manifests as tiredness, and slightly elevated liver enzymes

  1. Four stages of Chronic hepatitis B are immune tolerance phase, immune clearance, immune control and state of immune escape
  2. 30 % of patients with chronic hepatitis B are at risk for cirrhosis and liver cancer
  3. Treatment strategy is to identify the patients who are at high risk for progressive liver disease and treating these patients with potent antiviral agents