Chronic hepatitis B infection: A workshop consensus statement and algorithm
Here, presented with an evidence-based algorithm, are workshop consensus recommendations on whom to screen for hepatitis B and when to pursue further evaluation and management.
Seeking out expertise in HBV patient management
When a patient with chronic HBV infection has moved into the immune active phase, consult with a provider who has expertise in HBV—whether you choose to refer or to co-manage the patient with the specialist—to obtain advice on further work-up and development of a long-term management and treatment strategy. Individuals with small liver tumors identified on ultrasound or an elevated AFP level require immediate referral to a clinician who treats HCC, such as a transplant hepatologist.
Ensuring the health of pregnant women
The CDC recommends that all pregnant women be tested for HBsAg at an early prenatal visit. Counsel women who are HBsAg-positive on what this status means for their own health, in addition to that of their newborn. If you are providing prenatal care, collect baseline data for ALT, HBe serology, and HBV DNA levels. Promptly refer any patient with an elevated ALT level to a specialist for care during pregnancy.
Acknowledgement
Medical writing services were provided by Theresa M. Wizemann, PhD, of Wizemann Scientific Communications, LLC, under contract with the Hepatitis B Foundation.
CORRESPONDENCE
Joan M. Block, RN, BSN, executive director, Hepatitis B Foundation, 3805 Old Easton Road, Doylestown, PA 18902; joan.block@hepb.org
