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Chronic Active Hepatitis B
Mar 7, 1997

Just in need of some clarification. I was told probably eight years ago after having hepatitis B that it was chronic active. I have never paid much attention to that aspect of my health. My focus has always been on HIV, and I have not had any more episodes with it. What exactly does it mean? Does it ever correct itself? Have I been contagious all these years? Your opinion is greatly appreciated.

Response from Dr. Cohen

Between 5 to 10% of people who develop acute hepatitis B will become chronically infected. Of those, 70% develop chronic persistent hepatitis (CPH) and 30% develop chronic active hepatitis (CAH). Although the only sure way to tell the difference is to do a liver biopsy, CPH is generally milder -- people usually have no symptoms, just periodic elevations in their liver function tests. Those with CAH sometimes have jaundice and more severe liver function test abnormalities, and some will go on to develop cirrhosis.

To tell you what it means for you I'd have to know more details about your HIV infection and your hepatitis. In most cases the HIV is the more immediate problem, but that is not always the case.

You have been infectious for eight year, since you first developed hepatitis B. If you have the HBeAg ("e antigen") in addition to the HBsAg ("surface antigen") then you are even more infectious. However, since HIV and hepatitis B virus are transmitted the same way, you don't need to take any additional precautions other than the ones you take to avoid transmitting HIV infection.

This is a good opportunity for a public service announcement: if you've never had hepatitis B, get vaccinated!

Opportunistic Infections and Group Dynamics

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