Reactivation and Flare of Chronic Hepatitis B: Natural History, Diagnosis, Therapy and Prevention

Suharjo Broto Cahyono(1*), Neneng Rasari Neneng Rasari(2), Putut Bayupurnama(3), Sutanto Maduseno(4), Siti Nurdjanah(5)

(*) Corresponding Author


Almost 30% of the world population has been exposed to hepatitis B virus (HBV) and 400 million
of these are chronically infected. 20–30% of HBsAg carriers may develop reactivation or fl are (acute
exacerbation) of chronic hepatitis B with elevation of biochemical levels, high serum HBV DNA level with or
without sero-coversion to HBeAg. In countries with intermediate or high endemicity for HBV, compounded
in use cytotoxic or immunosuppressive therapy for the treatment of a wide variety of clinical disease,
reactivation or fl are may be the fi rst presentation of HBV infection. Sometime it is diffi cult to differentiate
between acute hepatitis B and reactivation (fl are). Accurate diagnosis in these cases is very important for
deciding whether to start treatment or not, because acute hepatitis B does not require treatment, while
reactivation or fl are may take benefi t from it. Effort to early detect, to treat and to prevent the reactivation
or fl are of chronic hepatitis B is very crucial to reduce morbidity and mortality.
Keywords: Reactivation, fl are (acute exacerbation) of chronic hepatitis B, acute hepatitis B, nucleos(t)ide

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