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Hepatitis B - Management
How do I manage chronic hepatitis B?
- Inform the Health Protection Unit to facilitate surveillance.
- Partner notification and contact tracing is usually undertaken through the local Health Protection Unit. It includes notifying any sexual contacts or needle-sharing partners during the infectious period (which is usually the 2 weeks before the onset of jaundice, until the person becomes HBsAg negative; although this period may be years in the case of chronic infection).
- Vaccination for hepatitis B should be offered to sexual partners, other household members (including children), and other contacts at high risk.
- Refer all people who test positive for hepatitis B surface antigen (HBsAg) to a specialist (hepatologist, infectious diseases physician, or gastroenterologist — depending on local protocol). Severe chronic hepatitis B requires rapid referral. Referral may involve:
- Further testing (such as detailed serology and measurement of viral load [hepatitis B virus-DNA], testing for immunity to hepatitis A, and screening for hepatitis C and HIV).
- Consideration of antiviral treatment.
- Follow up and monitoring (this may be shared between primary care and secondary care).
- Vaccinate the person against hepatitis A — if they are not immune to hepatitis A.
- Provide the person with information about hepatitis B, and advice on how to prevent transmission of the infection.
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