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__NOTOC__
{{Hepatitis B}}
{{CMG}}; {{AE}} {{JS}}, {{SaraM}}
==Overview==
==Overview==
Individuals are at increased risk of HBV infection if they:
Common risk factors in the development of HBV infection include sexual contact with infected individuals, sharing a household with a carrier, [[intravenous drug use]], travel to [[endemic]] regions, [[perinatal]] transmission from infected mothers to infants, and certain occupations.


*have sex with someone infected with HBV
==Risk Factors==
*have sex with more than one partner
Individuals who are at increased risk of [[hepatitis B infection]] include:<ref name="WHO-Hepatitis-B_2003">World Health Organization. Department of Cummunicable Disease Surveillance and Response http://apps.who.int/iris/bitstream/10665/67746/1/WHO_CDS_CSR_LYO_2002.2_HEPATITIS_B.pdf</ref><ref name="USPTF-Hepatitis-B">US. Preventive Services Task Force. Screening for Hepatitis B infection. (2014) https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/hepatitis-b-virus-infection-screening-2014?ds=1&s=hepatitis%20b Accessed on October 4th, 2016</ref>
*shoot drugs
* Infants born to [[infected]] mothers
*are a man and have sex with a man
* Young children in day-care or residential settings with other children in [[endemic]] areas
*live in the same house with someone who has chronic (long-term) HBV infection  
* Sexual/household contacts of [[infected]] persons
*have a job that involves contact with human blood
*Patients and employees in [[hemodialysis]] centers
*are a client in a home for the developmentally disabled
* Injection drug users sharing unsterilized needles
*have hemophilia
* People sharing unsterilized medical or dental equipment
*travel to areas where hepatitis B is common (country listing)
* People providing or receiving acupuncture and/or tattooing with unsterilized medical devices
* Persons living in regions or travelling to regions with [[endemic]] hepatitis B
**Country of origin is the major risk factor for HBV infection (prevalence threshold of 2% or greater to define countries with high risk for HBV infection)
* Sexually active heterosexuals
* Lack of [[vaccination]] in infancy
* Men who have sex with men
* [[Hemophilia]] patients
* Travel to areas where hepatitis B is common


One out of 20 people in the United States will get infected with HBV some time during their lives.  
Frequent and routine exposure to [[blood]] or [[serum]] is the common denominator of healthcare occupational exposure.<ref name="WHO">{{cite web | title = Hepatitis B | url = http://www.who.int/csr/disease/hepatitis/HepatitisB_whocdscsrlyo2002_2.pdf }}</ref>
{|
|[[image:Hbvrisk.png|700px|thumb|center|Source: https://www.cdc.gov/]]
|[[image:Hbvperinatal.png|700px|thumb|center|Source: https://www.cdc.gov/]]


Their risk is higher if their parents were born in Southeast Asia, Africa, the Amazon Basin in South America, the Pacific Islands, or the Middle East.  
|}
 
===Hepatitis B Reactivation===
Hepatitis B virus presents in all patients with infection. Patients who are either HBsAg-positive or anti HBc-positive are at the risk of hepatitis B reactivation.
 
Patients are at risk for HBV reactivation in the following conditions:<ref name="pmid23111095">{{cite journal| author=Lee YH, Bae SC, Song GG| title=Hepatitis B virus (HBV) reactivation in rheumatic patients with hepatitis core antigen (HBV occult carriers) undergoing anti-tumor necrosis factor therapy. | journal=Clin Exp Rheumatol | year= 2013 | volume= 31 | issue= 1 | pages= 118-21 | pmid=23111095 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23111095  }} </ref><ref name="pmid22392695">{{cite journal| author=Kim PS, Ho GY, Prete PE, Furst DE| title=Safety and efficacy of abatacept in eight rheumatoid arthritis patients with chronic hepatitis B. | journal=Arthritis Care Res (Hoboken) | year= 2012 | volume= 64 | issue= 8 | pages= 1265-8 | pmid=22392695 | doi=10.1002/acr.21654 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22392695  }} </ref><ref name="pmid6105519">{{cite journal| author=Sagnelli E, Manzillo G, Maio G, Pasquale G, Felaco FM, Filippini P et al.| title=Serum levels of hepatitis B surface and core antigens during immunosuppressive treatment of HBsAg-positive chronic active hepatitis. | journal=Lancet | year= 1980 | volume= 2 | issue= 8191 | pages= 395-7 | pmid=6105519 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6105519  }} </ref><ref name="pmid3884951">{{cite journal| author=Nair PV, Tong MJ, Stevenson D, Roskamp D, Boone C| title=Effects of short-term, high-dose prednisone treatment of patients with HBsAg-positive chronic active hepatitis. | journal=Liver | year= 1985 | volume= 5 | issue= 1 | pages= 8-12 | pmid=3884951 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3884951  }} </ref><ref>Europian Medicines Agency. reviews direct-acting antivirals for hepatitis C. (2016) http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Direct-acting_antivirals_for_hepatitis_C_20/Procedure_started/WC500203479.pdf </ref><ref name="FDA">U.S Food and Drug Adminestration. Drug Safety Communication: FDA warns about the risk of hepatitis B reactivating in some patients treated with direct-acting antivirals for hepatitis C http://www.fda.gov/downloads/Drugs/DrugSafety/UCM523499.pdf</ref>
*Receive immunosuppressive therapy
**[[Chemotherapy agents]]
**[[Tumor necrosis factor inhibitor|Tumor necrosis factor (TNF) inhibitor]] ([[Infliximab]])
**[[Methotrexate]] (particularly following its withdrawal)
**[[Abatacept]]
**[[Ustekinumab]]
**Anti-CD 20 agents ([[Rituximab]] and [[Ofatumumab]])
**High to moderate dose [[glucocorticoids]]
*Patients treated with direct-acting antivirals for hepatitis C
**Daklinza
**Epclusa
**Exviera
**Harvoni
**Olysio
**Sovaldi
**Viekira Pak/ Viekira Pak XR
**Technivie
**Zepatier


== References ==   
== References ==   
{{Reflist|2}}  
{{Reflist|2}}
 
[[Category:Hepatitis|B]]
[[Category:Viruses]]
[[Category:Infectious disease]]
[[Category:Gastroenterology]]


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[[Category:Hepatology]]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2], Sara Mehrsefat, M.D. [3]

Overview

Common risk factors in the development of HBV infection include sexual contact with infected individuals, sharing a household with a carrier, intravenous drug use, travel to endemic regions, perinatal transmission from infected mothers to infants, and certain occupations.

Risk Factors

Individuals who are at increased risk of hepatitis B infection include:[1][2]

  • Infants born to infected mothers
  • Young children in day-care or residential settings with other children in endemic areas
  • Sexual/household contacts of infected persons
  • Patients and employees in hemodialysis centers
  • Injection drug users sharing unsterilized needles
  • People sharing unsterilized medical or dental equipment
  • People providing or receiving acupuncture and/or tattooing with unsterilized medical devices
  • Persons living in regions or travelling to regions with endemic hepatitis B
    • Country of origin is the major risk factor for HBV infection (prevalence threshold of 2% or greater to define countries with high risk for HBV infection)
  • Sexually active heterosexuals
  • Lack of vaccination in infancy
  • Men who have sex with men
  • Hemophilia patients
  • Travel to areas where hepatitis B is common

Frequent and routine exposure to blood or serum is the common denominator of healthcare occupational exposure.[3]

Source: https://www.cdc.gov/
Source: https://www.cdc.gov/

Hepatitis B Reactivation

Hepatitis B virus presents in all patients with infection. Patients who are either HBsAg-positive or anti HBc-positive are at the risk of hepatitis B reactivation.

Patients are at risk for HBV reactivation in the following conditions:[4][5][6][7][8][9]

References

  1. ↑ World Health Organization. Department of Cummunicable Disease Surveillance and Response http://apps.who.int/iris/bitstream/10665/67746/1/WHO_CDS_CSR_LYO_2002.2_HEPATITIS_B.pdf
  2. ↑ US. Preventive Services Task Force. Screening for Hepatitis B infection. (2014) https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/hepatitis-b-virus-infection-screening-2014?ds=1&s=hepatitis%20b Accessed on October 4th, 2016
  3. ↑ "Hepatitis B" (PDF).
  4. ↑ Lee YH, Bae SC, Song GG (2013). "Hepatitis B virus (HBV) reactivation in rheumatic patients with hepatitis core antigen (HBV occult carriers) undergoing anti-tumor necrosis factor therapy". Clin Exp Rheumatol. 31 (1): 118–21. PMID 23111095.
  5. ↑ Kim PS, Ho GY, Prete PE, Furst DE (2012). "Safety and efficacy of abatacept in eight rheumatoid arthritis patients with chronic hepatitis B." Arthritis Care Res (Hoboken). 64 (8): 1265–8. doi:10.1002/acr.21654. PMID 22392695.
  6. ↑ Sagnelli E, Manzillo G, Maio G, Pasquale G, Felaco FM, Filippini P; et al. (1980). "Serum levels of hepatitis B surface and core antigens during immunosuppressive treatment of HBsAg-positive chronic active hepatitis". Lancet. 2 (8191): 395–7. PMID 6105519.
  7. ↑ Nair PV, Tong MJ, Stevenson D, Roskamp D, Boone C (1985). "Effects of short-term, high-dose prednisone treatment of patients with HBsAg-positive chronic active hepatitis". Liver. 5 (1): 8–12. PMID 3884951.
  8. ↑ Europian Medicines Agency. reviews direct-acting antivirals for hepatitis C. (2016) http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Direct-acting_antivirals_for_hepatitis_C_20/Procedure_started/WC500203479.pdf
  9. ↑ U.S Food and Drug Adminestration. Drug Safety Communication: FDA warns about the risk of hepatitis B reactivating in some patients treated with direct-acting antivirals for hepatitis C http://www.fda.gov/downloads/Drugs/DrugSafety/UCM523499.pdf

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