Ľubomír Skladaný, Elisabeth Lovrantová, Beáta Bachová
Infection by the hepatitis B virus, HBV is common, malicious and potentially fatal: at least 350 million people mostly in Asia, and other developing countries, as well as risk groups of population in other countries all over the world are afflicted.The disease presents inconclusive manifestation. According to WHO it is the 7th most common cause of death from all infectious diseases (mortality is 3 times higher than in hepatitis C). The death is caused by infection overlapped by i. fulminant form of acute hepatitis (rare), ii. complication of liver cirrhosis and iii. hepatocellular carcinoma (HCC) – each fourth or each second infected individual dies. Natural course, prognosis and treatment differs in infection by s.c. wild and mutant type of HBV infection. The prevention is active immunisation of the newborns and immunocompromised individuals from risk groups. Prevention of the onset of hepatitis B in patients with HBV infection after liver transplantation (LTx), immunosuppressive treatment and chemotherapy of tumors is performed by nucleotid analogues (NA). Pharmacological therapy of HBV infection is indicated in case of i. chronic, biochemically, virologically and histologically active hepatitis B (CHB), ii. rare life-threatening forms of acute hepatitis and unlike hepatitis C, also in case of iii. end stage of liver disease (ESLD). In one part of patients with ESLD the therapy can reverse the disease, in others stabilise the disease and gain the time for LTx. Therapy of infection in patients with ESLD should be llife-long. NA are used. The worst prognosis is in patients with undetected active infection with asymptomatic course, accidental examination of liver enzymes activity and persisting expression „healthy carrier“ of hepatitis B surface antigen, HbsAg.