Symptoms and Complications

The incubation period is approx 6 weeks to 6 months. As the name suggests, the virus primarily affects the liver. Typical symptoms include malaise, anorexia, nausea, mild fever, and abdominal discomfort and may last from 2 days to 3 weeks before the insidious onset of jaundice. Joint pain and skin rashes may also occur as a result of immune complex formation. Infections in the newborn are usually asymptomatic.

CHECK VIRUS SPECIFIC SECTION Hep B Hep C Hep D HIV

*In the United Kingdom, written consent from the contact must be sent with the sample, countersigned by the health care practitioner and, preferably, an independent police officer.

CHECK VIRUS SPECIFIC SECTION Hep B Hep C Hep D HIV

*In the United Kingdom, written consent from the contact must be sent with the sample, countersigned by the health care practitioner and, preferably, an independent police officer.

Fig. 1. Immediate management following occupational exposure to blood-borne viruses.

The majority of patients with acute HBV make a full recovery and develop immunity. After acute infection, approx 1 in 300 patients develop liver failure, which may result in death.

Chronic infection develops in approx 90% of neonates, approx 50% of children, and between 5 and 10% of adults. Neonates and children are usually

Table 1

Prevalence of Chronic Hepatitis B

Blood-doning population Intravenous drug users Homosexual/bisexuals Institutionalized patients People from high-risk endemic areas (e.g., China and the Far East)

no data available up to 30% of the population are carriers, and 75% have evidence of past infection; 5-10% are carriers (in Africa)

Table 2

Significance of Markers

Table 2

Significance of Markers

Name

Infectivity

Immunity

Risk after needlestick

HBsAg

Yes

No

Only marker = 10-20%

HBeAg

Yes

No

With HBsAg = 30-40%

HBeA

Yes

Yes

With HBsAg = <10%

HBCA

No

Yes

0%

HBSA

No

Yes

0%

HBsAg, hepatitis B surface antigen; HbeAg, hepatitis B e antigen; HbeA, hepatitis B e antibody; HBCA, hepatitis B core antibody; HBSA, hepatitis B surface antibody.

HBsAg, hepatitis B surface antigen; HbeAg, hepatitis B e antigen; HbeA, hepatitis B e antibody; HBCA, hepatitis B core antibody; HBSA, hepatitis B surface antibody.

asymptomatic. Adults may have only mild symptoms or may also be asymptomatic. Approximately 15-25% of chronically infected individuals (depending on age of acquisition) will develop cirrhosis over a number of years. This may also result in liver failure or other serious complications, including hepa-tocellular carcinoma, though the latter is rare. The overall mortality rate of HBV is estimated at less than 5%.

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