Treatment Guideline Chart

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%20b Treatment

Liver Transplantation

  • Indicated in patients with end-stage liver disease (cirrhosis), hepatocellular carcinoma, and acute liver failure (ie caused by viruses, drugs and toxic agents)
    • Considered in patients with expected survival of ≤1 year without transplantation or if quality of life is unsatisfactory due to the liver disease
  • Patients with HBV infection should be evaluated for liver transplantation despite antiviral therapy as development of liver failure cannot be predicted
    • Combination therapy with hepatitis B immunoglobulin and nucleos(t)ide analogues helps prevent HBV recurrence in these patients undergoing liver transplantation
  • Recipient patients without anti-HBs should receive prophylaxis for HBV recurrence if transplanted liver is anti-HBc positive
  • HDV replication is not a contraindication for liver transplantation
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