hepatitis%20b
HEPATITIS B

Hepatitis B is transmitted through perinatal, percutaneous, sexual, and close person-to-person contact, ie by open cuts and sores.

Human hepatitis B virus belongs to the family of Hepadnaviridae of small, enveloped, primarily hepatotropic DNA viruses. The virus replicates in the host and assembles exclusively in the hepatocytes and virions are released non-cytopathically through the cellular secretory pathway.

Chronic hepatitis B is defined as a chronic necroinflammatory liver disease due to persistent hepatitis B virus infection.

Hepatitis D infection is found only in patients with hepatitis B as it requires the hepatitis B outer coat. It is transmitted through sexual and percutaneous (especially IV drug use) routes.

Hepatitis B and D both have an incubation period of 30-180 days.

Hepatitis B References

  1. Workowski KA, Berman S, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. MMWR. 2010 Dec;59(RR-12):1-110. http://www.ncbi.nlm.nih.gov/pubmed. Accessed 01 Jun 2012. PMID: 21160459
  2. Entecavir (Baraclude) for chronic hepatitis B. Med Lett Drugs Ther. 2005 Jun;47(1210):47-48. http://www.ncbi.nlm.nih.gov/pubmed/?term=15933618. PMID: 15933618
  3. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2002. MMWR. 2002 May;51(RR-6):59-66. http://www.ncbi.nlm.nih.gov/pubmed/12184549. PMID: 12184549
  4. Ancell CD, Phipps J, Young L. Thymosin alpha-1. Am J Health Syst Pharm. 2001 May;58(10):879-885. https://www.ncbi.nlm.nih.gov/pubmed/?term=11381492. PMID: 11381492
  5. Cooksley WG. Peginterferon-alpha 2a for the treatment of hepatitis B infection. Expert Opin Pharmacother. 2005 Jul;6(8):1373-1380. PMID: 16013986
  6. European Association for the Study of the Liver. EASL clinical practice guidelines: management of chronic hepatitis B virus infection. Mar 20, 2012. J Hepatol. 2012 Jul;57(1):167-185. doi: 10.1016/j.jhep.2012.02.010. PMID: 22436845
  7. Gish RG. Current treatment and future directions in the management of chronic hepatitis B viral infection. Clin Liver Dis. 2005 Nov;9(4):541-565. doi:10.1016/j.cld.2005.08.005. PMID: 16207563
  8. Lau GK, Piratvisuth T, Luo KX, et al. Peginterferon alfa-2a lamivudine, and the combination of HBeAg-positive chronic hepatitis B. N Engl J Med. 2005 Jun;352(26):2682-2695. doi: 10.1056/NEJMoa043470. PMID: 15987917
  9. Liaw YF, Kao JH, Piratvisuth T, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update. Hepatol Int. 2012 Jun;6(3):531-561
  10. Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology. 2007 Feb;45(2):507-539. doi: 10.1002/hep.21513. PMID: 17256718
  11. Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Jul 28, 2009. Hepatol. 2009 Sep;50(3):001-36. doi: 10.1002/hep.23190. PMID: 19714720
  12. Rudolph A, Wang G, Sherman KE, et al. Therapeutic strategies for liver disease. Gastroenterol Hepatol. 2006 Jul;2(7):003-12.
  13. Radcliffe K. European STD guidelines. Int J STD AIDS. 2001 Oct;12(Suppl 3):1-102. http://www.iusti.org. PMID: 11589789
  14. Ryder SD, Beckingham IJ. ABC of diseases of liver, pancreas and biliary system: acute hepatitis. BMJ. 2001 Jan;322(7279):151-153. http://www.ncbi.nlm.nih.gov/pubmed/?term=11159575. PMID: 11159575
  15. Rutherford AE. Acute viral hepatitis. Merck Manual; 2013 Mar. http://www.merckmanuals.com/. Accessed 02 Oct 2013.
  16. Rutherford AE. Chronic hepatitis. Merck Manual; 2013 Mar. http://www.merckmanuals.com/. Accessed 02 Oct 2013.
  17. Liaw YF, et al. 2008 Guidelines for HBV management: summary of recommendations. Mar 2008
  18. Ministry of Health Singapore, Gastroenterological Society of Singapore, National Medical Research Council. Clinical practice guidelines: chronic hepatitis B infection. http//www.moh.gov.sg. Mar 2003.
  19. National Guideline Clearinghouse. Association for Genitourinary Medicine, Medical Society for the Study of Venereal Disease. Complete summary of 2002 national guideline on the management of viral hepatitides A, B, C. http://www.guideline.gov.
  20. College of Paediatrics, Academy of Medicine Malaysia. Malaysian immunisation manual. http://www.acadmed.org.my/. 2001.
  21. Negro F, Lok ASF. Pathogenesis, epidemiology, natural history, and clinical manifestations of hepatitis D virus infection. UpToDate. http://www.uptodate.com/index. May 2012. Accessed 03 Aug 2012
  22. Scientific Working Group on Viral Hepatitis Prevention, Dept of Health. Recommendations on hepatitis B vaccination regimens in Hong Kong. Jan 2001
  23. Negro F, Lok ASF. Treatment and prevention of hepatitis D virus infection. UpToDate. http://www.uptodate.com/index. Jan 2012. Accessed 03 Aug 2012
  24. Wolf DC. Viral hepatitis. eMedicine. http://www.emedicine.com/. 2004.
  25. Sarri G, Westby M, Bermingham S, et al; Guideline Development Group. Diagnosis and management of chronic hepatitis B in children, young people, and adults: summary of NICE guidance. BMJ. 2013 Jun;346:f3893. doi: 10.1136/bmj.f3893. Accessed 07 Oct 2014. PMID: 23804177
  26. Hepatology Society of the Philippines (HSP). 2014 HSP consensus statements on the management of chronic hepatitis B. HSP website. http://www.liverphil.org/. 2014.
  27. Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137. http://www.cdc.gov/. Accessed 17 Aug 2016. PMID: 26042815
  28. World Health Organization. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection. WHO. http://www.who.int/. Mar 2015. Accessed 08 Jul 2015.
  29. Sarin SK, Kumar M, Lau GK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int. 2016 Jan;10(1):1-98. doi: 10.1007/s12072-015-9675-4. Accessed 05 Aug 2016. PMID: 26563120
  30. Korean Association for the Study of the Liver (KASL). KASL clinical practice guidelines: management of chronic hepatitis B. Clin Mol Hepatol. 2016 Mar;22(1):18-75. doi: 10.3350/cmh.2016.22.1.18. PMID: 27044762
  31. European Association for the Study of the Liver. EASL 2017 Clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol. 2017 Aug;67(2). doi: 10.1016/j.jhep.2017.03.021. Accessed 12 Sep 2017. PMID: 28427875
  32. Terrault NA, BzowejNH, Chang KM, et al. American Association for the Study of Liver Diseases (AASLD) guidelines for treatment of chronic hepatitis B. Hepatology. 2016 Jan;63(1):261-283. doi: 10.1002/hep.28156. PMID: 26566064
  33. Lim SG, Aghemo A, Chen PJ, et al. Management of hepatitis C virus infection in the Asia-Pacific region: an update. Lancet Gastroenterol Hepatol. 2017 Jan;2(1):52-62. doi: 10.1016/S2468-1253(16)30080-2. PMID: 28404015
  34. Petruzziello A, Marigliano S, Loquercio G, et al. Global epidemiology of hepatitis C virus infection: an up-date of the distribution and circulation of hepatitis C virus genotypes. World J Gastroenterol. 2016 Sep 14;22(34):7824-7840. doi: 10.3748/wjg.v22.i34.7824. PMID: 27678366
  35. Centers for Disease Control and Prevention. Adult immunization schedule. Recommended immunization schedule for adults aged 19 years or older, by vaccine and age group, United States, 2017. CDC. https://www.cdc.gov/vaccines. 06 Feb 2017.
  36. European Association for the Study of the Liver. EASL clinical practice guidelines: liver transplantation. J Hepatol. 2016 Feb;64(2):433-485. doi: 10.1016/j.jhep.2015.10.006. PMID: 26597456
  37. Lok ASF. Hepatitis B virus: overview of management. UpToDate. https://www.uptodate.com. 29 Sep 2017.
  38. Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018 Apr;67(4):1560-1599. doi: 10.1002/hep.29800. PMID: 29405329
  39. World Health Organization (WHO). Hepatitis B. WHO. http://www.who.int. 18 Jul 2018.
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Jairia Dela Cruz, 05 Oct 2020
Drinking more than two cups of coffee per day may just be the intervention that prevents hundreds of thousands of liver disease‐related deaths globally, a study reports.
Pearl Toh, 21 Sep 2020
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
Roshini Claire Anthony, 12 Oct 2020

Insulin icodec, an in-development basal insulin analogue administered once weekly, was as effective as once-daily insulin glargine in patients with type 2 diabetes (T2D) insufficiently controlled with metformin with or without a DPP-4* inhibitor, according to a phase II trial presented at EASD 2020.

Stephen Padilla, Yesterday
Use of systemic corticosteroids does not reduce in-hospital mortality for patients with severe or critical coronavirus disease (COVID-19), which is in stark contrast to that observed in the RECOVERY clinical trial, according to a study in Wuhan, China.