key features:
- Hepatitis affects 1 % of the population in Australia
- The main viral investigation for HBV is HBsAg (surface antigen), if detected, indicating hepatitis B positive or carrier, a full viral profile is then formed.
- Monitor progress with 6-12 monthly LFTs, HBeAg and HBV DNA
- negative HBeAg and HBV DNA (with anti-HBe) = resolving, with anti-HBs = full recovery
- Positive HBeAg and HBV DNA = replicating and infective - refer
- Monitor LFTs every 6 months. Refer if ALT elevated
- Treatment: no specific treatment initially. Advise avoidance of ETOH, avoid certain drugs e.g. sedatives, NSAIDs, OCP, until recovery (normal LFTs).
- Treatment of chronic hepatitis B infection (abnormal LFTs) is with immunomodulatory and antiviral agents - pegylated interferon alpha and lamivudine.
- Refer any HBsAg positive patient with an abnormal ALT and/or signs of chronic liver disease to a specialist since the evaluation of chronic hepatitis B can be complex
Reference:
http://crmpub.ashm.org.au/product/Decision%20Making%20in%20HBV%202015_71497B8BAFEDE211AB9F984BE173A384/HBV_DecisionMaking_Jan2015.pdf
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