Hepatitis B history and symptoms: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hepatitis B}} | {{Hepatitis B}} | ||
{{CMG}};{{AE}} {{JM}} | {{CMG}}; {{AE}} {{JM}} | ||
==Overview== | ==Overview== | ||
50% of adult patients and the majority of infants and children with acute HBV do not present with symptoms. | 50% of adult patients and the majority of infants and children with acute HBV do not present with symptoms. Symptoms may initially be non-specific.<ref name="CDC">Center for Disease Control and Prevention. Hepatitis B Epidemiology and Prevention of Vaccine-Preventable Diseases 2012.http://www.cdc.gov/vaccines/pubs/pinkbook/hepb.html</ref> Proper and thorough history-taking is important in both acute and chronic HBV infections in order to determine modes of infection transmission, as well as to assess [[risk factors]] for the progression of HBV-related [[liver disease]].<ref name="pmid19399815">{{cite journal| author=Rotman Y, Brown TA, Hoofnagle JH| title=Evaluation of the patient with hepatitis B. | journal=Hepatology | year= 2009 | volume= 49 | issue= 5 Suppl | pages= S22-7 | pmid=19399815 | doi=10.1002/hep.22976 | pmc=PMC2881483 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19399815 }} </ref><ref name="pmid19714720">{{cite journal| author=Lok AS, McMahon BJ| title=Chronic hepatitis B: update 2009. | journal=Hepatology | year= 2009 | volume= 50 | issue= 3 | pages= 661-2 | pmid=19714720 | doi=10.1002/hep.23190 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19714720 }} </ref> | ||
==History== | ==History== | ||
Part of the initial evaluation for HBV infection includes a thorough patient history focusing on potential modes and timing of infection. Aspects covered in the patient's history include:<ref name="pmid19399815">{{cite journal| author=Rotman Y, Brown TA, Hoofnagle JH| title=Evaluation of the patient with hepatitis B. | journal=Hepatology | year= 2009 | volume= 49 | issue= 5 Suppl | pages= S22-7 | pmid=19399815 | doi=10.1002/hep.22976 | pmc=PMC2881483 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19399815 }} </ref> | Part of the initial evaluation for HBV infection includes a thorough patient history focusing on potential modes and timing of infection. Aspects covered in the patient's history include:<ref name="pmid19399815">{{cite journal| author=Rotman Y, Brown TA, Hoofnagle JH| title=Evaluation of the patient with hepatitis B. | journal=Hepatology | year= 2009 | volume= 49 | issue= 5 Suppl | pages= S22-7 | pmid=19399815 | doi=10.1002/hep.22976 | pmc=PMC2881483 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19399815 }} </ref> | ||
*Exposure to blood and/or blood products | *Exposure to blood and/or blood products | ||
*[[Intravenous drug use|Injection drug use]]([[IDU]]) | *[[Intravenous drug use|Injection drug use]] ([[IDU]]) | ||
*Sexual exposure | *Sexual exposure | ||
*Occupational exposure | *Occupational exposure | ||
| Line 24: | Line 24: | ||
*[[Drug abuse]] | *[[Drug abuse]] | ||
*Sexual activity | *Sexual activity | ||
*History of previous HBV treatment(to assess potential for treatment resistance) | *History of previous HBV treatment (to assess potential for treatment resistance) | ||
*[[Antiretroviral]] drug regimen if coinfected with [[HIV]](to assess potential for treatment resistance) | *[[Antiretroviral]] drug regimen if coinfected with [[HIV]] (to assess potential for treatment resistance) | ||
===Patients from Areas of High Endemicity=== | ===Patients from Areas of High Endemicity=== | ||
History taking among immigrants from regions with a high prevalence of HBV should include questions regarding family history of acute and/or [[chronic liver disease]], rituals in which shared and | History-taking among immigrants from regions with a high prevalence of HBV should include questions regarding family history of acute and/or [[chronic liver disease]], rituals in which shared and non-sterile instruments were used (e.g., scarification, piercing), and traditional medical procedures.<ref name="pmid19399815">{{cite journal| author=Rotman Y, Brown TA, Hoofnagle JH| title=Evaluation of the patient with hepatitis B. | journal=Hepatology | year= 2009 | volume= 49 | issue= 5 Suppl | pages= S22-7 | pmid=19399815 | doi=10.1002/hep.22976 | pmc=PMC2881483 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19399815 }} </ref> | ||
==Symptoms== | ==Symptoms== | ||
Approximately 50% of adults with acute [[HBV]] infections are [[asymptomatic]]. However, clinical symptoms occur more often in adults than in infants or children, who usually have an asymptomatic acute course.<ref name="CDC">Center for Disease Control and Prevention. Hepatitis B Epidemiology and Prevention of Vaccine-Preventable Diseases 2012.http://www.cdc.gov/vaccines/pubs/pinkbook/hepb.html</ref> | Approximately 50% of adults with acute [[HBV]] infections are [[asymptomatic]]. However, clinical symptoms occur more often in adults than in infants or children, who usually have an asymptomatic, acute course.<ref name="CDC">Center for Disease Control and Prevention. Hepatitis B Epidemiology and Prevention of Vaccine-Preventable Diseases 2012.http://www.cdc.gov/vaccines/pubs/pinkbook/hepb.html</ref> | ||
Symptoms can include:<ref name="CDC">Center for Disease Control and Prevention. Hepatitis B Epidemiology and Prevention of Vaccine-Preventable Diseases 2012.http://www.cdc.gov/vaccines/pubs/pinkbook/hepb.html</ref> | |||
*[[Fever]] | *[[Fever]] | ||
*Fatigue | *[[Fatigue]] | ||
*Nausea | *[[Nausea]] | ||
*Vomiting | *[[Vomiting]] | ||
*[[Loss of appetite]] | *[[Loss of appetite]] | ||
*[[Abdominal pain]] | *[[Abdominal pain]] | ||
*Dark urine | *Dark urine | ||
*Clay-colored bowel movements | *[[Acholic stools|Clay-colored bowel movements]] | ||
*[[Joint pain]] | *[[Joint pain]] | ||
*Yellowish discoloration of the eyes and skin | *Yellowish discoloration of the eyes and skin | ||
*Skin rash | *[[Skin rash]] | ||
*[[Muscle pain]] | *[[Muscle pain]] | ||
== References == | |||
{{Reflist|2}} | |||
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[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category: | [[Category:FinalQCRequired]] | ||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Hepatology]] | |||
Latest revision as of 22:04, 29 July 2020
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Hepatitis B |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jolanta Marszalek, M.D. [2]
Overview
50% of adult patients and the majority of infants and children with acute HBV do not present with symptoms. Symptoms may initially be non-specific.[1] Proper and thorough history-taking is important in both acute and chronic HBV infections in order to determine modes of infection transmission, as well as to assess risk factors for the progression of HBV-related liver disease.[2][3]
History
Part of the initial evaluation for HBV infection includes a thorough patient history focusing on potential modes and timing of infection. Aspects covered in the patient's history include:[2]
- Exposure to blood and/or blood products
- Injection drug use (IDU)
- Sexual exposure
- Occupational exposure
- Family history of HBV
- Recent history of invasive procedures performed in non-hospital health care settings, including hemodialysis centers and long-term care facilities[4]
Chronic HBV
In chronic HBV, history taking includes obtaining information regarding factors associated with the progression of HBV-related liver disease.[3] The following aspects should be covered:[3][2]
- Risk factors for coinfection with HDV, HCV, and HIV
- Family history of liver disease and HCC
- Medication history
- Smoking status
- Alcohol consumption
- Drug abuse
- Sexual activity
- History of previous HBV treatment (to assess potential for treatment resistance)
- Antiretroviral drug regimen if coinfected with HIV (to assess potential for treatment resistance)
Patients from Areas of High Endemicity
History-taking among immigrants from regions with a high prevalence of HBV should include questions regarding family history of acute and/or chronic liver disease, rituals in which shared and non-sterile instruments were used (e.g., scarification, piercing), and traditional medical procedures.[2]
Symptoms
Approximately 50% of adults with acute HBV infections are asymptomatic. However, clinical symptoms occur more often in adults than in infants or children, who usually have an asymptomatic, acute course.[1]
Symptoms can include:[1]
- Fever
- Fatigue
- Nausea
- Vomiting
- Loss of appetite
- Abdominal pain
- Dark urine
- Clay-colored bowel movements
- Joint pain
- Yellowish discoloration of the eyes and skin
- Skin rash
- Muscle pain
References
- ↑ 1.0 1.1 1.2 Center for Disease Control and Prevention. Hepatitis B Epidemiology and Prevention of Vaccine-Preventable Diseases 2012.http://www.cdc.gov/vaccines/pubs/pinkbook/hepb.html
- ↑ 2.0 2.1 2.2 2.3 Rotman Y, Brown TA, Hoofnagle JH (2009). "Evaluation of the patient with hepatitis B." Hepatology. 49 (5 Suppl): S22–7. doi:10.1002/hep.22976. PMC 2881483. PMID 19399815.
- ↑ 3.0 3.1 3.2 Lok AS, McMahon BJ (2009). "Chronic hepatitis B: update 2009". Hepatology. 50 (3): 661–2. doi:10.1002/hep.23190. PMID 19714720.
- ↑ Thompson ND, Perz JF, Moorman AC, Holmberg SD (2009). "Nonhospital health care-associated hepatitis B and C virus transmission: United States, 1998-2008". Ann Intern Med. 150 (1): 33–9. PMID 19124818.