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Hepatitis B

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Issue link: https://eguideline.guidelinecentral.com/i/100168

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Key Points ����An estimated 350 million persons worldwide are chronically infected with the hepatitis B virus (HBV). ����In the United States, there are an estimated 1.25 million hepatitis B carriers, defined as persons positive for hepatitis B surface antigen (HBsAg) for more than 6 months. ����Carriers of HBV are at increased risk of developing cirrhosis, hepatic decompensation, and hepatocellular carcinoma (HCC). ����Although most carriers will not develop hepatic complications from chronic hepatitis B, 15% to 40% will develop serious sequelae during their lifetime. Definitions ����Chronic hepatitis B: Chronic necroinflammatory disease of the liver caused by persistent infection with HBV. Chronic hepatitis B can be subdivided into hepatitis B e antigen (HBeAg) positive and HBeAg negative chronic hepatitis B. ����Inactive HBsAg carrier state: Persistent HBV infection of the liver without significant, ongoing necroinflammatory disease. ����Resolved hepatitis B: Previous HBV infection without further virologic, biochemical or histological evidence of active virus infection or disease. ����Acute exacerbation or flare of hepatitis B: Intermittent elevations of aminotransferase activity to more than 10 times the upper limit of normal and more than twice the baseline value. ����Reactivation of hepatitis B: Reappearance of active necroinflammatory disease of the liver in a person known to have the inactive HBsAg carrier state or resolved hepatitis B. ����HBeAg clearance: Loss of HBeAg in a person who was previously HBeAg positive. ����HBeAg seroconversion: Loss of HBeAg and detection of anti-HBe (antibody to ABeAg) in a person who was previously HBeAg positive and anti-HBe negative. ����HBeAg reversion: Reappearance of HBeAg in a person who was previously HBeAg negative, anti-HBe positive.

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