Hepatitis B Virus

One-Sentence Definition

Hepatitis B virus (HBV) is a partially double-stranded DNA hepadnavirus causing acute and chronic hepatitis, cirrhosis, and hepatocellular carcinoma — preventable by highly effective subunit vaccination.

Taxonomy & Morphology

  • Hepadnaviridae; small enveloped DNA virus
  • Replicates via RNA intermediate (reverse transcriptase) — not a retrovirus

Virulence Highlights

  • cccDNA persistence in nucleus → chronicity
  • HBsAg, anti-HBc, anti-HBs serologic patterns define infection phase
  • High chronicity risk if acquired perinatally

Clinical Syndromes

  • Acute hepatitis (± fulminant)
  • Chronic hepatitis → cirrhosis, HCC
  • Occult HBV (low-level DNA, complex serology)

Diagnosis

MarkerMeaning
HBsAgActive infection
anti-HBc IgMAcute/recent
anti-HBsImmunity (vaccine or recovery)
HBV DNA PCRViremia; treatment monitoring

Treatment / Prevention

  • Vaccine (HBsAg) — neonatal schedule cornerstone (Vaccination)
  • PEP: HBIG + vaccine after exposure
  • Chronic: antivirals (tenofovir, entecavir) — long-term suppression

Active Recall

  1. Which serology pattern indicates vaccine immunity?
  2. Why is perinatal acquisition high risk for chronicity?
  3. HBV DNA vs HBsAg roles?