Hepatitis B infection (Kiswahili: “Homa ya ini”)

Notes
  • Causes acute and chronic infection
  • Parenteral spread
  • Infection increases risk of hepatocellular carcinoma
Symptoms
  • Acute hepatitis;

_Fever

_Malaise

_Jaundice, itchness dark urine and light stool due to increased plasma levels of bilirubin.

_Elevated levels of ALT and AST in LFTs

_Elevated WBCs levels

Diagnosis
  • History: risky sexual activity and possibility of being being IV Drug User should be considered.
  • HBsAg test (Hepatitis B Surface Antigen Test)
  • HBcAb IgM test (Hepatitis B core Antibody IgM), which signifies the presence of active infection in positive cases.
  • HBsAb test (Hepatitis B Surface antigen Antibody) which signifies past infection or effective vaccination in positive cases.
  • HBeAg test (Hepatitis B e antigen test), which signifies presence of active HBV replication and high infectivity in positive cases.
  • Persons who have recovered from HBV infection will be positive for HBsAb and HBcAb but negative for other markers
  • Molecular diagnostic (PCR RNA levels).
Management
  • Supportive treatment
  • Vaccination
  • HBC immunoglobulins
  • Peglated interferon alpha 2b
  • Lamivudine:

_Dose: Children above 12yrs and adults; 100mg OD. For children 2-11yrs; 3mg/kg OD (max. 100mg daily). HIV/HBV co-infection: 150mg BD.

  • Tenofovir

_Dose:300mg depending creatinine clearance (CCr). For CCr 30-49ml/min: 300mg after every 48hrs. For CCr 10-29ml/min: 300mg twice a week. For CCr less than 10ml/min do not use tenofovir. Taken with meal

  • Entecavir
  • Adefovir
  • Telbivudine

_ Dose: 600mg OD (for adult only)

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