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Semin Liver Dis 2005; 25: 3-8
DOI: 10.1055/s-2005-915644
Published in 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Epidemiology and Natural History of Hepatitis B

Brian J. McMahon1
  • 1Scientific Program and Clinical Director, Liver Disease and Hepatitis Program, Alaska Native Medical Center, Anchorage, Alaska; Associate Clinical Professor, University of Washington School of Medicine, Seattle, Washington
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Publication History

Publication Date:
16 August 2005 (online)

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ABSTRACT

Hepatitis B virus (HBV) is a common viral pathogen that currently infects an estimated 4 million people worldwide, including 400 million who have chronic infection. Persons with chronic HBV infection are at a lifelong risk of developing hepatocellular carcinoma (HCC) or cirrhosis, or both. Many persons with HBV are unaware that they carry the infection, and, of those who are chronically infected, only a minority receives routine, scheduled follow-up to monitor their disease status. Persons from high-risk populations, especially immigrants from nations where hepatitis B is highly endemic, should be tested for HBV seromarkers and should be vaccinated if they are found to be negative. The natural history of chronic HBV is a dynamic one: patients can fluctuate between periods of active liver inflammation and periods of inactive disease. Disease progression is influenced by various factors, including viral genotype and specific mutations, demographic features, concurrent viral infections, and social and environmental factors. Recent data suggest that antiviral therapy can decrease the risk of liver decompensation and liver-related death and reduce the risk of HCC in selected individuals with active liver disease and severe fibrosis. Persons identified with chronic HBV infection need lifelong, regular monitoring for the development of active liver disease and HCC.

KEYWORDS

Hepatitis B virus - natural history - management - epidemiology

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Brian J McMahonM.D. 

Director, Viral Hepatitis Program, Alaska Native Medical Center

ANMC 4315 Diplomacy Drive, Anchorage, AK 99503

Email: bdm9@cdc.gov

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