Viral Hepatitis

Chronic viral hepatitis tends to be either hepatitis B or hepatitis C.

Hepatitis B: A hepatitis B carrier is defined as someone who is HBsAg (hepatitis B surface antigen) positive. The majority of patients are anti HBe antibody positive (anti HBeAb) and HBeAg negative (hepatitis B antigen negative). Infection is likely to have been acquired in childhood, but not necessarily.

In this instance we measure HBV DNA. If the HBV DNA is <2000 IU/ml with normal liver function tests, then no treatment is necessary, just simple observation every 6 months.

If HBV DNA is consistently >2000 IU/ml then I recommend entecavir or tenofovir monotherapy for at least five years. Some patients spontaneously seroconvert during this time but the majority do not with the virus returning after cessation of treatment.

Chronic Hepatitis C: Patients with hepatitis C are HCV antibody positive. Approximately 15-20% of patients with hepatitis C will spontaneously clear the virus and be HCV RNA negative on testing. The majority do not. Chronic hepatitis C can be a debilitating disease with chronic fatigue and multiple symptomatology. In the past we used to treat with pegylated interferon and ribavirin wi awful side effects. The treatment now is much simpler and much more effective with 98% cure rates and very few side effects. When treatment starts patients often feel much better as the virus load decreases. The type of treatment you receive depends to some extent on the genotype you have.

Hepatitis C can be cured within 12 weeks of treatment with hardly any side effects in the majority.

I can also advise on hepatitis A and E