High risk populations for HBV infection (as discussed earlier), as well as their sexual and family contacts and all pregnant women, should be screened for HBV infection with HBsAg.

The newly diagnosed patient with HB should undergo a full medical history and physical examination. Emphasis should be placed on trying to identify risk factors for HBV infection and coinfection with hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Factors such as alcohol use, which may aggravate liver disease, should be identified. Family history of HB and HCC should be sought and sexual contacts and household members at risk for infection should be identified for screening and appropriate HBV vaccination.

Initial examinations of a patient with chronic HBV infection should include tests that evaluate liver inflammation, liver function, and viral replication. Serum aminotransferases give a crude indication of ongoing liver injury or inflammation. Bilirubin, albumin and prothrombin time (PT) reflect hepatic synthetic function, although they will generally remain normal until there is a critical loss of hepatic function. As previously discussed, testing for HBeAg, HBeAb and HBV DNA are essential in evaluating the replica-tive state of the virus. In patients with identified risk factors, HCV and HIV antibody tests should be ordered.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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