Hepatitis B, Chronic
Description Diagnostic criteria Referral ICD-10 code: B18.1 DESCRIPTION Persistently elevated transaminases after hepatitis B infection. DIAGNOSTIC CRITERIA Transaminases are double upper limit of normal. Liver biopsy is characteristic. Hepatitis B serology positive. Interpretation of Hepatitis B Serological Test Results Susceptible: HBsAg negative Anti-HBc negative anti-HBs negative IgM an
Description
Diagnostic criteria
Referral
ICD-10 code: B18.1
DESCRIPTION
Persistently elevated transaminases after hepatitis B infection.
DIAGNOSTIC CRITERIA
- Transaminases are double upper limit of normal.
- Liver biopsy is characteristic.
- Hepatitis B serology positive.
Interpretation of Hepatitis B Serological Test Results
| Susceptible: | |
| HBsAg | negative |
| Anti-HBc | negative |
| anti-HBs | negative |
| IgM anti-HBc | negative |
| Immune due to vaccination: | |
| HBsAg | negative |
| Anti-HBc | negative |
| anti-HBs | positive > 10 milli-units/mL |
| Immune from natural infection: | |
| HBsAg | negative |
| Anti-HBc | positive |
| anti-HBs | positive |
| Acute infection: | |
| HBsAg | positive |
| Anti-HBc | positive |
| anti-HBs | negative |
| IgM anti-HBc | positive |
| Chronic infection: | |
| HBsAg | positive |
| Anti-HBc | positive |
| anti-HBs | negative |
| IgM anti-HBc | negative |
- Four possible interpretations:
- Recovering from acute HBV infection.
- Distantly immune anti-HBs level too low to detect.
- Susceptible with false positive anti-HBc.
- Chronic infection with HBsAg levels too low to detect.
HBsAg - negative
Anti-HBc - positive
anti-HBs - negative
REFERRAL
- For confirmation of diagnosis and initiation of treatment.
Standard Treatment Guidelines and Essential Medicines List for South Africa Paediatric Hospital _2023, 5th edition_Updated July 2024
Chapter 2: Alimentary Tract, 2.3 Hepatic Disease, 2.3.5 Hepatitis B, Chronic