Ask the Experts
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
- 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
