Management of Hepatitis B Infection

  • Authors: Harry L. A. Janssen, MD, PhD; Milan J. Sonneveld, MD, PhD, MSc (More Info)
  • Editor In Chief: Stefan Zeuzem, MD
  • Last Reviewed: 5/25/18 (What's New)



  • Chronic HBV infection affects an estimated 257 million people globally
    • Most cases in southeast Asia and sub-Saharan Africa[WHO HBV]
  • Without treatment, HBV may progress over time to liver disease, fibrosis, and cirrhosis, leading to hepatocellular carcinoma and death
  • Successful anti-HBV therapy reduces disease progression
  • International guidelines recommend anti-HBV treatment in patients with persistent necroinflammation and viral replication
    • Nucleos(t)ide analogues or peginterferon are recommended first-line therapy options

Management of Acute Hepatitis B Virus Infection

  • The course of acute HBV infection depends on age at infection[Liaw 2009a]
    • Presentation is usually subclinical in neonates and symptomatic in up to one third of adults
    • Early symptoms include influenza-like symptoms, gastrointestinal symptoms, and fatigue, followed by dark urine, pale stool, and jaundice
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