Chronic Active Viral Hepatitis B: How Serious Is It?

Chronic active viral hepatitis B is categorized in clinical practice into mild, moderate, and severe forms. The severe type tends to present with more pronounced symptoms, including significant fatigue, abdominal bloating, loss of appetite, and an aversion to fatty foods. Some patients may develop jaundice, which manifests as a chronic liver disease appearance, yellowing of the skin and eyes, spider angiomas, and enlargement of the liver and spleen.

In terms of laboratory findings, liver function tests show considerable impairment. For example, alanine aminotransferase (ALT) and bilirubin levels may rise more than five times above the upper limit of normal. Additionally, serum albumin levels may drop below 32g/L, and the albumin-to-globulin ratio decreases. Coagulation tests also reflect declining liver function, with prothrombin activity ranging between 40% and 60%, and decreased cholinesterase levels, typically under 4500U/L.

Patients with this condition often require hospitalization due to the severity of their illness, and treatment can be more complex. However, with timely and appropriate medical intervention, the prognosis is generally favorable. Delayed treatment or exposure to triggers such as infections, physical exhaustion, or alcohol consumption can lead to worsening liver damage and even liver failure. Moreover, in cases where treatment is not properly followed or managed, the disease may progress over time, potentially leading to cirrhosis.

Early diagnosis and consistent management are crucial in preventing complications and improving long-term outcomes for individuals with chronic active hepatitis B. Regular monitoring and lifestyle adjustments, such as avoiding alcohol and maintaining a healthy diet, play a significant role in supporting liver health.