Hepatitis B virus

Hepatitis B virus (HBV) is a circular DNA virus endemic in many parts of the world. It is a risk factor for the development of hepatocellular carcinoma (HCC).

Clinical presentation

Acute HBV infection is most often subclinical and asymptomatic. Symptomatic patients (~33%) may experience fever, nausea and/or jaundice. Rarely (1%) it causes acute liver failure .


Route of transmission

The most common route of transmission is regionally-dependent. In endemic areas, vertical transmission from mother to child is more common. In other areas, contaminated needles, blood products, and unprotected sex is more common.

  • genotype A: sub-Saharan Africa
  • genotype B: Japan and East Asia
  • genotype C: China, Korea, Japan, Southeast Asia
    • most closely associated with HCC
  • genotype D: Eastern Europe, North Africa, Russia, Middle East, India
  • genotype E: West Africa
  • genotypes F, G, H: Central and South America

Treatment and prognosis

Vaccination programs have been effective in many parts of the world to decrease the incidence of disease.

Patients with chronic hepatitis B may benefit from a hepatocellular carcinoma screening program.

Related pathology

Acute infection with the hepatitis B virus may result in acute hepatitis.

Chronic infection with hepatitis B is a risk factor for the development of hepatocellular carcinoma (HCC). The patient may either be cirrhotic or non-cirrhotic.