Management of hepatitis B
Volume 40-13, July 10, 2014: Hepatitis B
Summary of the Primary Care Management of Hepatitis B – Quick reference
Gale-Rowe M1*, Latham-Carmanico C1, Lalonde F1, Wong T1 on behalf of the authors and contributors
1 Public Health Agency of Canada, Ottawa, ON
Hepatitis B (HB) virus is a highly infectious vaccine-preventable disease. Canada is a region of low endemicity; however, certain vulnerable populations, including Aboriginal peoples, men who have sex with men, street-involved youth and people who are or have been incarcerated, are disproportionately affected. The low prevalence is mainly attributable to universal HB immunization programs, which are available and accessible in all provinces and territories.
In Canada, an estimated 300,000 individuals are chronically infected with HB, which represents less than 1% of Canadians. Data suggest that of those affected with chronic HB, 70% are immigrants from highly endemic regions. Two thirds of chronically infected people are unaware of their status. In the absence of appropriate intervention 15% to 40% of them will have long-term sequelae of HB, such as cirrhosis, end-stage liver disease and/or hepatocellular carcinoma, and in addition can infect others There is an urgent need to screen, diagnose and treat, where appropriate, chronic HB infection in order to reduce the associated morbidity and mortality and to prevent further transmission.
The objective of the Primary Care Management of Hepatitis B – Quick Reference (Quick Reference)Footnote 1 is to assist primary care and public health practitioners in the prevention, screening and management of HB in patients at risk of or infected with HB. This document provides a brief summary.
The Quick Reference does not supersede any provincial/territorial legislative, regulatory, policy and practice requirements or professional guidelines that govern and inform the practice of care providers in their respective jurisdictions.
The Quick Reference was developed by the Public Health Agency of Canada in collaboration with working group members with expertise in HB, HIV and related co-infections. The content of this clinical resource reflects current published information and evidence-based resources, such as the Management of Chronic Hepatitis B: Canadian Association for the Study of the Liver Consensus GuidelinesFootnote 2 and was tailored on input from expert hepatologists, laboratory specialists, public health practitioners, physicians and nurses.
The content of the Quick Reference is divided into 11 modules and includes links to credible resources to support the most recent immunization, treatment and other management recommendations. Table 1 identifies the titles of all the modules and provides a short summary of the content available in each module.
The Quick Reference is a very useful and practical clinical resource for primary care and public health professionals, as it guides them through all the main steps for the complete management of HB and refers them to credible resources already available for treatment, immunization and management recommendations.
Many thanks to the authors:
Andonov A, Ling R, Baril JG, Myers R, Brubacher C, Osiowy C, Butler G, Pritchard LM, Gale-Rowe M, Verkoeyen J, Heathcote J, Yim C, Latham-Carmanico C.
Many thanks to the contributors, the Centre for Communicable Diseases and Infection Control and the Centre for Immunization and Respiratory Infectious Diseases at the Public Health Agency of Canada.
Conflicts of interest
There are no conflicts of interest to declare.
This project was funded by the Public Health Agency of Canada.
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