Hepatitis B history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
50% of adult patients and the majority of children with acute HBV do not present with symptoms. When present, symptoms may be non-specific. 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.[1]
History
Part of the initial evaluation for HBV infection include a thorough patient history focusing on potential modes and timing of infection. Aspects covered in the patient's history include:[1]
- 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[2]
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 such as scarification and piercing, and traditional medical procedures.[1]
In chronic HBV, history taking includes obtaining information regarding factors associated with the progression of HBV-related liver disease.
The following aspects should be covered:CITE TWICE
- Risk factors for coinfection with HDV, HCV, and HIV(CITE)
- 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)
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.[4]
Symptoms can include:
- Fever
- Fatigue
- Nausea
- Vomiting
- Loss of appetite
- Abdominal pain
- Dark urine
- Clay-colored bowel movements
- Joint pain
- Yellowish discoloration of the eyes and skin
References
- ↑ 1.0 1.1 1.2 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.
- ↑ 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.
- ↑ Lok AS, McMahon BJ (2009). "Chronic hepatitis B: update 2009". Hepatology. 50 (3): 661–2. doi:10.1002/hep.23190. PMID 19714720.
- ↑ 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
Template:STD/STI Template:WH Template:WS
Overview
History
Part of the initial evaluation for HBV infection include a thorough patient history focusing on potential modes and timing of infection.[1]
Aspects covered in the patient's history include:[1]
- 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[2]
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 such as scarification and piercing, and traditional medical procedures.[1]
In patients with chronic HBV, history taking should focus on the following:[1]
- Risk factors for coinfection
- Medication history
- Smoking status
- Alcohol consumption
- Drug abuse
- Sexual activity
- History of previous HBV treatment
- Anti-retroviral drug regimen if coinfected with HIV
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.[3]
Symptoms can include:
- Fever
- Fatigue
- Nausea
- Vomiting
- Loss of appetite
- Abdominal pain
- Dark urine
- Clay-colored bowel movements
- Joint pain
- Yellowish discoloration of the eyes and skin
References
- ↑ 1.0 1.1 1.2 1.3 Klug WA, Capelhuchnick P, Gagliardi D, Oriente L (1979). "[Intestinal occlusion caused by spontaneous hematoma of the colon in a leukemia patient]". Rev Paul Med. 93 (1–2): 21–4. PMID 288148.
- ↑ 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.
- ↑ 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