Hepatitis B: A Crash Course

Yu-Ming ChangOctober 21, 2014

Prevalence of Chronic HBV Infection Age 19-49 in 2005

http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/hepatitis-b

HCC Screening

• Africans over 20 years of age• Asian men over 40 years• Asian women over 50 years• Any carrier over 40 years with persistent or

intermittent ALT elevation and/or high HBV DNA level >2,000 IU/mL

• Cirrhosis• Family history of HCC

Take Home Points

• HBV infection can be complicated but treatment is simple

• HBV-induced transaminitis can wax/wane• Persistently normal ALT with HBS antigen positivity do

not require treatment• Chronic HBV: get CMP, INR, CBC, HBV DNA before

referring to hepatology• Don’t forget co-infections: HCV, HDV, HIV• Don’t forget vaccination: HAV, flu, Pneumococcal• Don’t forget HCC screen in non-cirrhotic patients