Dr. Arthur Kim shares insights on Hepatitis B screening, vaccination, treatment, and counseling. Topics include interpreting test results, chronic HBV infection stages, preventing transmission, antiviral treatment, and screening for hepatocellular carcinoma.
CDC recommends universal hepatitis B screening to increase coverage and identify candidates for vaccination or treatment.
Various hepatitis B vaccine options available including combination vaccines and adjuvanted vaccines to improve immune responses.
Interpreting hepatitis B serology results crucial for guiding decisions on vaccination, monitoring, and treatment strategies.
Deep dives
Understanding Hepatitis B Screening Guidelines
The CDC now recommends that all adults should be screened for hepatitis B at least once in their lifetime, as opposed to previous risk-based screening. This change aims to increase screening coverage and identify individuals who may benefit from vaccination or treatment.
Different Hepatitis B Vaccine Options
Various hepatitis B vaccine options are available, including the traditional three-dose vaccine, a combination vaccine with hepatitis A, and newer adjuvanted vaccines like Prehebrio and CPG. These vaccines offer improved immune responses and may be particularly useful in non-responders or high-risk populations.
Interpreting Hepatitis B Serology Results
Interpreting hepatitis B serology results involves understanding markers like core antibody, surface antigen, and surface antibody. Different combinations of these markers indicate exposure, immunity, or active infection. Proper interpretation guides decisions on vaccination, monitoring, and treatment strategies.
Managing Chronic Hepatitis B Cases
Chronic hepatitis B infection progresses through phases like immune-tolerant, immune-active, and inactive phases. Monitoring ALT levels, viral load, and serologic markers helps assess disease activity and determine the need for treatment. Early detection, risk assessment, and ongoing monitoring are crucial in managing chronic hepatitis B infections.
Transmission Misconceptions About Hepatitis B and C
Breastfeeding does not transmit hepatitis B or hepatitis C, contrary to some misconceptions. Unexpectedly, toothbrush sharing poses a higher risk due to microabrasions, leading to hygienic concerns. Sharing of bites or drinks is also discouraged to prevent transmission of hepatitis B. Patients may carry stigma due to shame associated with the diagnosis, impacting their mental health and well-being.
Liver Preservation and Treatment Approaches for Hepatitis B
Oral hygiene and lifestyle factors like excessive alcohol consumption and obesity are crucial for liver preservation in chronic hepatitis B patients. Medications like Tenofovir or Entecavir are commonly used for treatment, with considerations for safety and efficacy. Treatment initiation is influenced by factors like ALT levels and viral load, with ongoing monitoring to assess response and potential endpoints for treatment continuation or cessation, drawing attention to ongoing research for potential novel treatment options.
Become a pro in Hepatitis B! Dr. Arthur Kim teaches us how to approach Hepatitis B screening and vaccination in primary care, provides pearls on counseling patients with chronic Hepatitis B infection, and summarizes considerations for Hepatitis B antiviral treatment and monitoring.