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Hepatitis B: Screening, Prevention, Diagnosis, and Treatment
Thad Wilkins1, Richard Sams1, Mary Carpenter1
1Medical College of Georgia at Augusta University, Augusta, GA, USA.
American Family Physician
|February 28, 2019
Summary
Hepatitis B virus (HBV) screening and vaccination are crucial for preventing acute and chronic liver infections. Effective treatments for chronic hepatitis B can reduce risks of cirrhosis and liver cancer.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Hepatitis B virus (HBV) causes acute and chronic liver disease.
- Screening is recommended for pregnant women, at-risk adolescents, and adults.
- Vaccination is advised for infants, children, and unvaccinated adults.
Purpose of the Study:
- To define acute and chronic hepatitis B.
- To outline screening and vaccination recommendations.
- To discuss treatment strategies for chronic hepatitis B.
Main Methods:
- Diagnosis of acute hepatitis B relies on symptoms, jaundice, elevated ALT, and positive HBsAg and HBcAg tests.
- Chronic hepatitis B is defined by persistent HBsAg for over six months.
- Liver disease staging guides treatment and surveillance for hepatocellular carcinoma.
Main Results:
- Antiviral treatment is ineffective for acute hepatitis B.
- Chronic hepatitis B increases risk of cirrhosis and hepatocellular carcinoma.
- Adequate treatment reduces morbidity and mortality.
Conclusions:
- Individualized treatment for chronic hepatitis B is essential.
- Immunologic cure is achievable with current therapies.
- Pegylated interferon alfa-2a, entecavir, and tenofovir are recommended first-line treatments.
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