BMJ  2004;329:1080-1086 (6 November), doi:10.1136/bmj.329.7474.1080

Clinical review

Preventing and treating hepatitis B infection

¹ Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014, India

The first 150 words of the full text of this article appear below.

Introduction

Hepatitis B virus infection is a global public health problem, with approximately 400 million people chronically infected.^{1 2} Each year it causes more than 500 000 deaths worldwide. Outcome of acute hepatitis B virus infection ranges from asymptomatic subclinical infection (70%) and symptomatic acute hepatitis (30%) to fulminant hepatic failure (0.1-0.5%).³ A proportion of people infected with hepatitis B virus (5%-10% among adults) progress to chronicity, defined as persistence of infection for more than six months.⁴ The rate of chronicity is much higher among neonates and children. The spectrum of chronic hepatitis B virus infection ranges from the asymptomatic carrier state to chronic hepatitis B, liver cirrhosis, and hepatocellular carcinoma. The clinical course of hepatitis B virus infection is complex and is influenced by several factors (box 1). Overall, chronic hepatitis progresses to end stage liver disease in 15-40% of patients.⁵ The pathophysiology of chronic hepatitis B virus infection has been . . . [Full text of this article]

Prevention of hepatitis B virus infection

General measures
Hepatitis B vaccine
Prevention of hepatitis B virus transmission in special settings

Treatment of chronic hepatitis B virus infection

Who needs treatment?
Treatment end points
Treatment options
General advice
Interferon
Lamivudine
Adefovir
Combination treatment
Liver transplantation in hepatitis B virus related liver disease
Patients in special categories
Summary

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