Not recommended in persons coinfected with HIV because of possible development of HIV resistance need to monitor renal function Oral well tolerated moderate effectiveness low probability of resistance development Mild effectiveness moderate probability of resistance development need to monitor renal function Not well tolerated expensive subcutaneous injections cannot use in persons with decompensated liver disease or HIV infection No resistance highest seroconversion rate at one year finite treatment time Travelers to regions with intermediate or high rates of endemic HBV infectionĭurability of seroconversion at one year (%) † Susceptible household contacts or sex partners of persons identified as HBsAg positive Sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., persons with more than one sex partner during the past six months)
Residents and staff of facilities for persons who are developmentally disabled Persons with chronic liver disease end-stage renal disease (including predialysis, peritoneal dialysis, hemodialysis, and home dialysis) or human immunodeficiency virus infection Persons seeking protection from HBV infection (acknowledgment of a specific risk factor is not a requirement for vaccination) Persons seeking evaluation or treatment for a sexually transmitted infection Health care and public safety workers at risk of exposure to blood or blood-contaminated body fluids Persons with chronic hepatitis B virus infection should be monitored for disease activity with liver enzyme tests and hepatitis B virus DNA levels considered for liver biopsy and entered into a surveillance program for hepatocellular carcinoma.Ĭhildren and adolescents younger than 19 years who have not been vaccinated previously Treatment options include pegylated interferon alfa-2a administered subcutaneously or oral antiviral agents (nucleotide reverse transcriptase inhibitors). The goals of treatment for chronic hepatitis B virus infection are to reduce inflammation of the liver and to prevent complications by suppressing viral replication. The diagnosis of hepatitis B virus infection requires the evaluation of the patient's blood for hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody. Fewer than 5 percent of adults acutely infected with hepatitis B virus progress to chronic infection. Acute infection may cause nonspecific symptoms, such as fatigue, poor appetite, nausea, vomiting, abdominal pain, low-grade fever, jaundice, and dark urine and clinical signs, such as hepatomegaly and splenomegaly. Hepatitis B virus is transmitted in blood and secretions. Although an estimated 1 million persons in the United States are chronically infected with hepatitis B virus, the prevalence of hepatitis B has declined since the implementation of a national vaccination program.
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