Familial Screening A Must In HBV

Abstract

Introduction: Chronic hepatitis B Virus (HBV) infection is an important cause of cirrhosis of liver for which effective treatment is available but still significant number of patients require liver transplantation when it reaches end stage liver disease. There are various routes of transmission for HBV like parenteral, vertical, nosocomial and through close contact among family members of HBV patient. Familial prevalence in HBV is an important aspect and merits strict screening of all family members which can prove to be lifesaving for many.

Case Report: - We report a thirty-six-year-old male, not a known case of any chronic illness presented with bilateral pedal oedema for last one-month, abdominal distension and breathlessness on exertion for last two weeks. On evaluation he was diagnosed to be suffering from chronic hepatitis B related chronic liver disease (CLD) with decompensation in form of ascites with hepatocellular carcinoma (H.C.C) with portal vein thrombosis. On family evaluation he told that his on elder brother had died of HBV related H.C.C few years back and mother also died of HBV related CLD in past. His five brother and one sister were found to be HBV Positive and only one brother was HBV negative. on regular antiviral treatment for last five years.

Conclusion: The family members of every Hepatitis B patient should be screened for HBV infection. The positive members should be evaluated in detail for stage of disease and if needed treatment should be started on priority. In case of family history of HBV related hepatocellular carcinoma (H.C.C), other HBV positive patients with low viral load should also be treated with antiviral therapy. The members who are found to be HbsAg negative should be vaccinated with complete course of three doses of HBV vaccine.