Treatment of a Patient with HBeAg-negative Chronic Hepatitis B

Ian PUN, MD, Family Physician, Scarborough, Ontario with help from Anthony Vu, 4th Year student, University of Toronto undergraduate life science, Rob Myers, MD, Associate Professor of Medicine, Hepatologist, and Director of the Viral Hepatitis Clinic at the University of Calgary, Calgary, AB.

It is estimated that there are 350 million world wide carriers of the hepatitis B virus, mostly coming from Asia (Lai et al., 2005). With immigration of Chinese into Western countries, hepatitis B is now becoming established in countries where it was previously uncommon. Chronic hepatitis B infection is a prevalent disease especially in the Toronto and Vancouver areas where most Asians live. Fortunately, over the past decade effective anti-viral treatments have become available. Chronic hepatitis B is mostly an asymptomatic disease, therefore, serological and imaging tests should be used to identify, follow and treat those considered high risk.
Key Words: HBV DNA (hepatitis B DNA), cirrhosis, anti-viral tenofovir, FibroScan.


very good article /needs uniform medical funding -- some provinces vaccination is still not funded for adult population at risk.

Excellent and succinct article on this subject!

Since mid 1980's, prenatal screening for HBSAg carriers has become routine; but children of newer immigrant or refugee families from endemic countries may not be routinely screened. Identified silent carriers might not be followed up. It is important to inform carriers and their families to be screened and be monitored for long term complication and to receive the benefit of antiviral therapy. At my weekly small group teaching on Multicultural Health, at the Pediatric Concsultation Centre of the Montreal Children's Hospital,I found such practice has not been consistent known to family residents and medical students. I have been routinely teaching about the importance of screening and raising awareness among prevalent ethnic target groups of such public health implication on being HB carriers. More public education might be required.