Hepatitis B Virus

Hepatitis B Virus is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • HBV is a DNA virus in the hepadnavirus family. The United States is considered an area of low prevalence for the infection. Eight genotypes of HBV have been identified (A through H). The prevalence of HBV genotypes varies depending on the geographic location. Genotypes A, B, and C are the most prevalent in the United States.
  • Modes of transmission include vertical (mother to infant) and horizontal (person to person) via the following routes: parenteral or percutaneous (e.g., injection drug use, needlestick injuries), direct contact with the blood or open sores of an infected person, and sexual contact with an infected individual.
  • The rate of progression from acute to chronic HBV is approximately 90% for a perinatal-acquired infection, 20%–50% for infections acquired between the age of 1–5 years, and <5% for an adult-acquired infection.
  • Acute hepatitis B treatment is rarely needed unless there is severe hepatic dysfunction (prolonged jaundice, coagulopathy, or encephalopathy).

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