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Hepatitis B

From Mediwikis

Presents with symptoms of hepatitis: general malaise, loss of appetite, nausea, vomiting, aches, mild fever, dark urine, progressing to Jaundice

Virology

Within Hepatitis B, there are several distinct genotypes, based on their antigenic determinant, namely A-H, though the more common types are A-D. These genotypes have different geographical prevalences, latencies, response to interferon, and levels of damage to the liver.
While HBV targets hepatocytes for replication, it is not intrinsically cytopathic; damage results from the host's cellular immune response

Transmission

Vertical- from mother to child, either in utero, during birth, or soon thereafter
Horizontal- Particularly in children, via small injuries coming into contact with the Hep B virion. Also transmitted by infected blood, sharps, and sexual intercourse, particularly between two men.

Management

Interferon, Entecavir and Tenofovir are all used (Interferon is not used in those with cirrhosis) Monitoring of platelet levels, HBV DNA level and conversion of HBeAg to anti-HBe are used to judge response to therapy, and side effects.

Prognosis

Highly variable, though established cirrhosis is a sign of poor prognosis. One of the common consequences is hepatocellular carcinoma, so monitoring even after successful treatment is crucial.