Hepatitis B

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	Section 1 Section 2 Section 3 Section 4 Section 5 Appendices

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Section 3. Summaries of Infectious Diseases

Hepatitis B

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
Special Considerations

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CLINICAL MANIFESTATIONS: People with hepatitis B virus (HBV)infection may present with a variety of signs and symptoms,including subacute illness with nonspecific symptoms (eg, anorexia,nausea, or malaise), clinical hepatitis with jaundice, or fulminantfatal hepatitis. Asymptomatic seroconversion is common, andthe likelihood of developing symptoms of hepatitis is age dependent.Anicteric or asymptomatic infection is most common in youngchildren. Extrahepatic manifestations, such as arthralgias,arthritis, macular rashes, thrombocytopenia, or papular acrodermatitis(Gianotti-Crosti syndrome), can occur early in the course ofthe illness and may precede jaundice. Acute HBV infection cannotbe distinguished from other forms of acute viral hepatitis onthe basis of clinical signs and symptoms or nonspecific laboratoryfindings. Chronic HBV infection is defined as presence of hepatitisB surface antigen (HBsAg) in serum for at least 6 months orby the presence of HBsAg in a person who tests negative forantibody of the immunoglobulin (Ig) M subclass to hepatitisB core antigen (anti-HBc).

Age at the time of acute infection is the primary determinantof the risk of progressing to chronic infection. More than 90%of infants infected perinatally will develop chronic HBV infection.Between 25% and 50% of children infected between 1 and 5 yearsof age become chronically infected, whereas only 2% to 6% ofacutely infected older children and adults develop chronic HBVinfections. Patients who develop acute HBV infection while immunosuppressedor with an underlying chronic illness have an increased riskof developing chronic infection. Up to 25% of infants and olderchildren who acquire chronic HBV infection eventually developHBV-related hepatocellular carcinoma or cirrhosis.

The clinical outcome of untreated chronic HBV infection variesaccording . . . [Go to Full Text]

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