Patient comes for blood donation but he has HBs Ag and HBeAg positive, and serum transaminases level is normal. What would be the next step in management?
Since the patient has voluntarily donated blood it implies that he does not have any active liver disease. Recommendations for Treatment of Chronic Hepatitis B HBeAg Clinical HBV DNA ALT Recommendation Reactive Inactive/ mild disease >2 X 104 <2X Upper limit of normal No treatment; monitor. In patients >40, with family history of hepatocellular carcinoma, and/or ALT persistently at the high end of the two fold range, liver biopsy may help in decision to treat. Reactive Chronic hepatitis >2 X 104 >2X Upper limits of normal Treat Reactive Chronic compensated >2 X 103 Upper limits of normal Treat with oral agents, not PEG IFN Reactive Cirrhosis transplantation Detectable Upper limits of normal Treat with oral agents, not PEG IFN Refer for transplantation for Liver Undetectable Upper Limits of normal Observe; refer for liver transplantation
Treat with interferon
HBV DNA estimation
Liver biopsy
Observation
Hepatitis