Hepatitis B virus (HBV)

The hepatitis B virus (HBV) is an enveloped DNA virus that belongs to the family of Hepadnaviridae.

An infection with HBV can take very different courses. The course of the disease is mainly determined by the immune response of the infected person.

Acute hepatitis B

Acute hepatitis B is characterized by symptoms that last several weeks. These include yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting, and abdominal pain. Most hepatitis B disease in adults (>90%) heals completely and confers lifelong immunity. Only very rarely, acute liver failure and death occur.

Chronic hepatitis B

Acute hepatitis B can lead to a lifelong infection known as chronic hepatitis B. Chronic infection occurs when specific antibodies to HBV are detectable for more than six months. Over time, chronic hepatitis B can lead to serious health problems, including liver damage, cirrhosis of the liver, liver cancer, and death.

The most effective measure to protect against infection with HBV is a hepatitis B vaccination. Vaccination is especially recommended for employees in healthcare facilities.

Chronically HBV-infected people form the reservoir for HBV.

Relevance of pathogen in transmission in endoscopy

  • Gastroenterology: Low

  • Pulmonology: Not relevant

  • Ear, nose, and throat: Not relevant

  • Urology: Not relevant

Relevance for endoscope surveillance

  • Low or moderate concern organism

Transmission route

Hepatitis B viruses are mainly transmitted parenterally, e.g., through contact with contaminated blood or blood products, contaminated instruments (e.g., injecting drug use, tattoo studios), sexual contact, or injury.

In countries with a high incidence of virus carriers, perinatal transmission plays a significant role. In this case, the virus is passed on from the HBV-infected mother to her child during birth.

The risk of HBV transmission in the event of an improper endoscope reprocessing is uncertain. A few cases of HBV transmission have been documented in the literature. There is a risk of transmission if biopsy forceps are not properly reprocessed.

Sources and further readings

  1. Gries O, Ly T: Infektologie – Kompendium humanpathogener Infektionskrankheiten und Erreger, Springer-Verlag Berlin Heidelberg 2019.

  2. Hepatitis B, Centers for Disease Control and Prevention, https://www.cdc.gov/hepatitis/hbv/index.htm. Accessed on 05.14.2021.

  3. Hepatitis B, World Health Organization, https://www.who.int/news-room/fact-sheets/detail/hepatitis-b. Accessed on 05.14.2021.

  4. Hepatitis B und D, RKI-Ratgeber, https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_HepatitisB.html. Accessed on 05.14.2021.

  5. Kovaleva J. et al. Infectious complications in gastrointestinal endoscopy and their prevention, / Best Practice & Research Clinical Gastroenterology 30 (2016) 689-704.

  6. Petignat C. Infektionsübertragungsrisiko bei einer Endoskopie, Schweizerische Gesellschaft für Sterilgutversorgung. Journal Forum 2008; 3: 36–40.