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Hepatitis B (HBV)

Chronic HBV Infection — Serology, Phases, and Antiviral Therapy

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Hepatitis B (HBV)?

Hepatitis B is a partially double-stranded DNA virus transmitted parenterally, sexually, and perinatally, causing acute and chronic hepatitis.

Chronic HBV phases: immune-tolerant, immune-active (HBeAg-positive CHB), inactive carrier, and HBeAg-negative CHB — each with different treatment indications.

Diagnosis relies on HBsAg (active infection), anti-HBc IgM (acute), HBeAg, anti-HBe, and HBV DNA viral load.

Risk of progression to cirrhosis and hepatocellular carcinoma correlates with viral load, HBeAg status, and coinfection (HCV, HIV, HDV).

Symptoms

Acute hepatitis: fatigue, nausea, anorexia, jaundice, right upper quadrant pain
Chronic infection often asymptomatic for years
Serum sickness-like prodrome: arthralgia, urticarial rash
Dark urine, pale stool, hepatomegaly
Cirrhosis signs: ascites, encephalopathy, variceal bleeding, jaundice
Extrahepatic manifestations: polyarteritis nodosa, membranous glomerulonephritis

Risk Factors

Perinatal or early childhood exposure in endemic areas
Sexual or injection drug use transmission
Healthcare occupational exposure and needlestick injuries
Hemodialysis and multiple transfusions before screening
Cohabitation with chronic HBV carrier
Immigration from endemic regions (Asia, Sub-Saharan Africa)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Jaundice, fatigue, right upper quadrant pain, or abnormal liver enzymes
  • HBsAg positive test or household contact with chronic HBV
  • Pregnancy with HBV infection for prevention of perinatal transmission

Treatment Methods

01
Indications for antiviral therapy: chronic HBV with ALT elevation and HBV DNA over 2000 IU/mL, cirrhosis with any detectable DNA, HCC, or immunosuppression
02
First-line nucleos(t)ide analogues: entecavir, tenofovir disoproxil fumarate (TDF), or tenofovir alafenamide (TAF) — long-term suppressive therapy
03
Pegylated interferon alpha for selected young patients with low viral load, high ALT, and favorable genotype
04
HCC surveillance every 6 months with ultrasound (plus AFP) in cirrhosis, Asian men over 40, African-born over 20, family history
05
Prevention: universal infant vaccination, HBIG plus vaccine for newborns of HBsAg-positive mothers, screening of contacts
06
Screen and manage HIV, HCV, HDV coinfection; avoid alcohol; vaccinate against hepatitis A

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.