The management of hepatitis B

Abstract

Chronic hepatitis B affects almost 1% of Australians, many of whom are born in endemic areas outside Australia. This infection can shorten lifespan, usually because of cirrhosis or hepatocellular carcinoma. most patients acquire the infection perinatally or in childhood before migration. A small number of people acquire infection as adults via injecting drug use or sexual contact. Hepatitis B infection is usually asymptomatic, and screening using hepatitis B surface antigen should be considered for all patients from endemic countries and those with percutaneous or sexual risk factors. Improved laboratory testing for viral DNA can help identify the need for treatment and long-term risk of liver damage. Treatment is with nucleos(t)ide analogues (usually long-term) or pegylated interferon (for 12 months). This reduces inflammation, can improve liver injury and reduces progression to cirrhosis and hepatocellular carcinoma. long-term monitoring is recommended to detect reactivation of infection and hepatocellular carcinoma.