Chronic Hepatitis B Carrier

Aka: Chronic Hepatitis B Carrier, Hepatitis B Carrier

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II. Pathophysiology

  1. Acute Hepatitis B Infection becomes chronic in 10%
  2. Chronic Hepatitis B (HBsAg present >6 months)
    1. Chronic Hepatitis B Carrier
    2. Chronic Hepatitis B Infection
  3. Hepatitis B Carrier contrasted with chronic infection
    1. Low viral load
    2. Normal Liver Function Tests (ALT or SGPT)

III. Labs

  1. HBsAg positive
  2. HBeAg negative
  3. xHBeAb positive
  4. Liver Function Tests (ALT or SGPT) normal
  5. Low viral load: HBV DNA hybridization negative

IV. Management

  1. Observation: primary care visits every 6-12 months
  2. Follow related lab-work at follow-up visits
    1. Liver Function Tests (ALT or SGPT)
    2. HBsAg
    3. HBeAg
    4. xHBeAb

V. Course

  1. Spontaneous clearance in 1% of carriers per year
  2. Risk of reactivation to Chronic Hepatitis B Infection

VI. Prevention of Transmission

  1. Identify all potential exposures
    1. Children
    2. Household contacts
    3. Sexual contacts
  2. Hepatitis B Serology testing for all exposures
  3. Hepatitis B Vaccine for all exposures not immune

VII. References

  1. Berenguer in Feldman (2002) Sleisenger GI, p. 1285-303
  2. Lok (2001) Hepatology 34:1225-41 [PubMed]
  3. Malik (2000) Ann Intern Med 132:723-31 [PubMed]

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