National case definition: Hepatitis B

Hepatitis B

Date of last revision/review: May 2008

National notification

The following cases of disease should be notified:

• Confirmed acute
• Although it is recognized that chronic hepatitis B infections are not reportable in all provinces and territories, where possible, chronic and unspecified infections should be notified to the national level.

Type of surveillance

Routine case-by-case notification to the federal level

Case classification

Acute case

Confirmed case

• Hepatitis B surface antigen (HBsAg) and immunoglobulin M antibody to hepatitis B core antigen (anti-HBcIgM) positive in the context of a compatible clinical history or probable exposure

or

• Clearance of HBsAg in a person who was documented to be HBsAg positive within the last six months in the context of a compatible clinical history or probable exposure

Probable case

Acute clinical illness in a person who is epidemiologically linked to a confirmed case

Chronic carrier

Confirmed case

• HBsAg positive for more than 6 months

or

• Detection of HBsAg in the documented absence of anti-HBc-IgM

or

• Detection of HBV DNA for more than 6 months

Unspecified

Confirmed case

• Does not fit the criteria for either case above

and

• HBsAg positive

or

• Detection of HBV DNA

Laboratory comments

Occult HBV infection is characterized by a positive HBV DNA and presence of anti-HBc alone or anti-HBc and anti-HBs in the absence of HBsAg.

Further isolate characterization is indicated for epidemiologic public health and control purposes.

Clinical evidence

Acute clinical illness is characterized by a discrete onset of symptoms and jaundice or elevated serum aminotransferase levels. Chronic infections may present with disease flares with similar symptoms and signs.

ICD code(s)

ICD-10 code(s)

B16 Acute hepatitis B

B16.0 Acute hepatitis B with delta-agent (coinfection) with hepatic coma

B16.1 Acute hepatitis B with delta-agent (coinfection) without hepatic coma

B16.2 Acute hepatitis B without delta-agent with hepatic coma

B16.9 Acute hepatitis B without delta-agent and without hepatic coma

Hepatitis B (acute) (viral) NOS

B18.0, Chronic viral hepatitis B with delta-agent

B18.1 Chronic viral hepatitis B without delta-agent




ICD-9 code(s)

070.30 Hepatitis B (acute)

070.20 Hepatitis B (acute) with hepatic coma

070.21/31 Hepatitis B (acute) with hepatitis delta

V02.61 Hepatitis B (carrier status)

070.32 Hepatitis B (chronic)

070.22 Hepatitis B (chronic) with hepatic coma

070.23 Hepatitis B (chronic) with hepatitis delta

References

Public Health Agency of Canada. Case Definitions for Communicable Diseases under National Surveillance. Canada Communicable Disease Report. 2009; 35S2.