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Services > Family Medicine Service > Clinical Management of Chronic Hepatitis B

Clinical Management of Chronic Hepatitis B

Hepatitis B causes inflammation of the liver cells. In Hong Kong, about 8% population, that is, every 1 in 13 persons are Hepatitis B Virus (HBV) carriers. Approximately 25% to 40% of HBV carriers have long term damages in their livers which eventually leads to liver cirrhosis or cancer. People aged 40 or above, have smoking or drinking habits or male carriers who have close relatives with liver diseases are of the highest risk.

Hepatitis B is transmitted through blood and body fluid. It is spread by sharing needles or other sharp tools like tooth brushes, nail clippers, shavers, tattoo or blood transfusion tools, through unsafe sex or transmitted from the infected mother to her baby during birth. Symptoms include fever, tiredness, nausea, abdominal pain, jaundice and dark urine. However, many HBV carriers do not have signs and symptoms and thus are not aware that they have been infected.

  • Vaccination Against Hepatitis
  • You are recommended to take a HBV test to confirm whether you are a carrier (if the hepatitis B surface antigen remains positive for more than 6 months, you are considered as a HBV carrier). If confirmed not infected and HBV antibodies do not exist in your body, you should consider having Hepatitis B vaccine or Twinrix injection. High risk groups including those who have household or sexual contacts with carriers, people on kidney dialysis, people who receive blood or injections on a regular basis and health care workers should definitely go for vaccination to protect themselves. Please click here for pamphlet of Prevention and Screening of Hepatitis.

  • Regular Health Check
  • Since drugs that can suppress HBV are now available, HBV carriers should have regular body check (at least once every 6 months*) to closely monitor the activeness of the virus, so as to have early detection of any abnormal changes in liver and suppress HBV replication by anti-virus drug, thereby reducing the chance for developing liver cirrhosis or cancer.

    * Since it takes around 4 months for a liver tumor to grow to a size that is detectable by ultrasound, in order to avoid unnecessary expenditures and patient's anxiety, most doctors would recommend this interval.

    We provide the following check up plans for HBV carriers to closely monitor their liver condition:

      Ultrasound Liver & Spleen
    Basic Monitoring Package – LF12
    Virus Activity Monitoring Package – LF9
    Comprehensive Monitoring Package – LF7
    (for newly diagnosed HBV carriers or high risk cariers)
    ALT
       
    AFP    
    HBeAg
       
    HBV DNA
       
    USG Liver & Spleen (with report)
     
    Fee (HK$)

    $710

    $1,120

    $1,020

    $2,070

    Test for Additional Hepatitis A: HK$220
    Other Hepatitis B monitoring packages are available. Our registered medical professionals will offer you advice on package selection.

    What are the tests for?

  • Blood Test
  • ALT
    Indicates how severe the liver cells are inflamed
    AFP
    Liver cancer marker
    HBeAg
    Hepatitis B e-antigen, one of the indicators to help doctor decides when to start or stop treatment
    HBV DNA
    Test for virus activity

  • USG Liver & Spleen
  • An imaging test to help identify cirrhosis and abnormal growth in the organs

  • Hepatitis A & B Screening Packages
  • FAQs on Hepatitis
  • Hepatitis A

    1. What is Hepatitis A?
      Hepatitis A is one type of viral hepatitis. Some people with hepatitis A infection may not have any signs and symptoms of the disease. Onset of disease is usually abrupt with fever, loss of appetite, nausea, upper abdominal discomfort and jaundice. It has an incubation period of 2 to 6 weeks. Most patients have a complete recovery but in a few cases, the liver may be severely affected.

    2. How does Hepatitis A spread?
      Hepatitis A virus is transmitted from person to person and through food, drink, hands or items that has been contaminated with the stool of someone with hepatitis A infection.

    3. Do I need Hepatitis A vaccine?
      Hong Kong is a region with intermediate prevalence of hepatitis A. People who travel frequently to places with a high prevalence of hepatitis A and frequently eat uncooked shellfish will have a higher chance of getting infected. Those who have chronic liver disease(eg. Hepatitis B carriers)are at increased risk of having serious liver disease including cirrhosis and liver cancer if they get infected with Hepatitis A. Infected food handlers stand the high chance of spreading the virus to others. We recommend the abovementioned groups to be vaccinated against Hepatitis A.

    4. How long does protection from Hepatitis A last?
      Hepatitis A vaccine is highly effective in preventing hepatitis A infection. The vaccine is administered in two doses and protection against hepatitis A would last for 10 years or above.

    Hepatitis B

    1. What is Hepatitis B?
      Hepatitis B is a liver disease caused by the Hepatitis B virus. It can also progress into chronic infection and lead to chronic liver diseases, such as liver cirrhosis and liver cancer. More than 8% of the Hong Kong populations are Hepatitis B carriers and majority of them do not have any symptoms.

    2. How does Hepatitis B spread?
      In Hong Kong, Hepatitis B is mainly transmitted from infected mothers at the time of delivery and infancy period (perinatal transmission). Other possible routes of transmission include sexual contact or sharing injection instruments and daily necessities with an infected person, transfusion of infected blood or blood products, ear piercing or tattooing with contaminated instruments.

    3. Do I need Hepatitis B vaccine?
      Please consult the health care professionals for the appropriateness of Hepatitis B vaccination. Since the majority of patients do not have symptoms, individuals should have blood tests before vaccinated. Only people who have never been exposed to hepatitis B should have vaccination.

    4. How long does protection from Hepatitis B last?
      About 90 to 95% of people will gain life-long immunity to hepatitis B after a full course (3 doses) of vaccination.

    5. What is to be done if I am a Hepatitis B carrier?
      Although there is no cure for Hepatitis B, there are some drugs that may slow down the disease process of turning into cirrhosis and liver cancer. Regular blood test for liver function and ultrasound liver scan are able to determine the appropriateness of drug therapy. It is also important that chronic Hepatitis B carriers should avoid smoking, consuming alcohol and taking unknown medications as they increase their risk for cirrhosis and liver cancer. Getting vaccinated against Hepatitis A can also prevent further damage of liver.