Chronic Hepatitis B

Chronic hepatitis B progresses through different stages depending on viral activity and the immune system’s response. While some individuals may remain stable for years, others may experience worsening liver damage over time. The main stages include:

1. Immune Tolerant Phase – The hepatitis B virus (HBV) multiplies rapidly in the body, but the immune system does not attack it, resulting in little to no liver damage. This phase is more common in younger individuals.
2. Immune Active Phase – The immune system recognises and attacks HBV-infected liver cells, leading to inflammation and potential liver scarring.
3. Inactive Carrier State – The virus remains in the body but at very low levels, meaning there is little to no liver inflammation or damage. However, regular monitoring is still needed.
4. Reactivation Phase – The virus becomes active again, increasing viral replication and triggering liver inflammation, which can lead to further complications.

Over time, repeated inflammation can cause extensive liver scarring (cirrhosis), increasing the risk of liver failure or liver cancer. Since chronic hepatitis B does not always follow a predictable disease progression, regular monitoring is essential to detect changes early and guide appropriate management.

Chronic hepatitis B develops from a long-term infection with the hepatitis B virus, which can be transmitted through:

• Mother-to-child transmission – This is the most common cause of chronic hepatitis B, occurring when an infected mother passes the virus to her baby during childbirth. Because newborns and young children are more vulnerable, they have a significantly higher chance of developing chronic infection.
• Unprotected sexual contact – HBV can spread through bodily fluids, including blood, semen, and vaginal secretions.
• Sharing needles or syringes – Individuals who use injectable drugs or receive unsafe medical injections are at higher risk.
• Household transmission – Sharing personal items like razors or toothbrushes with an infected person can increase the risk.
• Blood transfusions and medical procedures – Although rare in countries with strict screening, HBV can be transmitted through contaminated blood products.

To differentiate between acute and chronic infection, the hepatitis B surface antigen (HBsAg) test must be persistently positive for at least six months before a chronic diagnosis is confirmed.

While chronic hepatitis B has no definitive cure, treatment aims to control viral replication, prevent liver damage, and reduce the risk of complications.

Treatment Approach	Purpose
Antiviral Medications	Antiviral drugs like entecavir, tenofovir, and lamivudine help reduce viral load, slow disease progression, and lower the risk of liver damage.
Regular Monitoring	Lifelong follow-up with liver function tests, HBV DNA testing (every 3 to 6 months), and imaging (such as ultrasound every 6 to 12 months) helps detect early signs of cirrhosis or liver cancer, enabling timely intervention.
Lifestyle Modifications	Avoiding alcohol and medications that can harm the liver, such as certain painkillers, helps prevent further liver damage. Maintaining a rich in fruits, vegetables, whole grains, and lean proteins supports liver function by providing essential nutrients and antioxidants. Regular exercise improves overall health and immunity, reducing the risk of complications.
Vaccination and Preventive Measures	Hepatitis B vaccination protects uninfected individuals from contracting the virus. Screening household members and sexual contacts for hepatitis B to help prevent transmission.

At ATA Medical, we provide screening for hepatitis B and if required, treatment for chronic or acute infections. Our prices are as follows:

Test	Price*
Consultation	From $38.15
Blood Tests
HEP 1 Profile Hepatitis B Surface Antigen (HBsAg), Hepatitis B Surface Antibody (HBsAb)	$21.80
HEP 5 Profile Hepatitis B Surface Antigen (HBsAg), Hepatitis B Surface Antibody (HBsAb), Hepatitis B e Antigen (HBeAg), Hepatitis B e Antibody (HBeAb), Alpha-Fetoprotein (AFP), ALT/SGPT, AST/SGOT, Gamma GT (GGT)	$87.20
Liver Function Test A Total Bilirubin, Alkaline Phosphatase [ALP], ALT/SGOT, AST/SGPT, Gamma GT	$30.52
Liver Function Test B Total Bilirubin, Alkaline Phosphatase [ALP], ALT/SGOT, AST/SGPT, Gamma GT, Total Protein, Albumin, Globulin, A/G Ratio	$34.88
Liver Function Test C Total Bilirubin, Alkaline Phosphatase [ALP], ALT/SGOT, AST/SGPT, Gamma GT, Total Protein, Albumin, Globulin, A/G Ratio, LDH, Hepatitis Bs Antigen & Antibody, Hepatitis A Total IgG, Alpha Fetoprotein [AFP]	$91.56
Imaging Tests
Ultrasound Liver	$150.42
Ultrasound Liver Elastography	$196.20
MR Liver Elastography	$566.80
MRI Abdomen (Kidney, Liver, Pancreas, Gallbladder & Spleen)	$1471.50
CT Liver (with contrast)	$1122.70
Vaccinations
Engerix-B® (Hepatitis B)	$54.50 / dose
Twinrix® (Hepatitis A & Hepatitis B)	$119.90 / dose
Havrix® (Hepatitis A)	$98.10 / dose

*Prices are NETT and inclusive of GST.

Chronic hepatitis B is a lifelong condition that requires early detection, regular monitoring, and proper management to prevent complications such as liver cirrhosis and cancer. While there is no cure, available treatments can help control the virus, protect liver function, and improve long-term health outcomes.

At ATA Medical, we provide comprehensive hepatitis B screening and personalised treatment plans to help you manage your condition with confidence. Schedule your hepatitis B screening with us today.

At ATA Medical, we strive to make a meaningful impact on every patient's health. With over 120,000 patients served, we are dedicated to fostering trust and enhancing well-being across our community.