{"id":1602,"date":"2018-08-23T09:48:28","date_gmt":"2018-08-23T09:48:28","guid":{"rendered":"https:\/\/fehv.org\/?page_id=1602"},"modified":"2018-08-23T09:55:16","modified_gmt":"2018-08-23T09:55:16","slug":"hepatitis-b","status":"publish","type":"page","link":"https:\/\/fehv.org\/en\/diseases\/hepatitis-b\/","title":{"rendered":"Hepatitis B"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"1602\" class=\"elementor elementor-1602 elementor-33 elementor-bc-flex-widget\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3256751e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3256751e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-76f49e39\" data-id=\"76f49e39\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-534cd36e elementor-widget elementor-widget-image\" data-id=\"534cd36e\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/fehv.org\/wp-content\/uploads\/2018\/06\/medical-appointment-doctor-healthcare-40568.jpeg\" title=\"\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-1f81ee7b\" data-id=\"1f81ee7b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-43858371 elementor-widget elementor-widget-text-editor\" data-id=\"43858371\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h4>What is Hepatitis B?<\/h4>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1fd61537 elementor-widget elementor-widget-text-editor\" data-id=\"1fd61537\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Hepatitis B is a <strong>viral infection of the liver<\/strong> that causes inflammation of the liver and death of hepatocytes (liver cells). It can occur as an acute infection that in 5% -10% of cases becomes chronic (when the infection is maintained for more than 6 months). Chronic infection can progress to liver cirrhosis and even liver cancer.<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5b763ece elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5b763ece\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-5d23e42b\" data-id=\"5d23e42b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-397609e9 elementor-widget elementor-widget-text-editor\" data-id=\"397609e9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h4>Causes of Hepatitis B<\/h4>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4f93e600 elementor-widget elementor-widget-text-editor\" data-id=\"4f93e600\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>It is caused by <strong>hepatitis B virus<\/strong> (HBV). The VBH belongs to the family of viruses called Hepadnaviridae and its genetic material is a DNA of 3,200 base pairs in length that has a circular shape. Occasionally, <strong>VBH infection is associated with another virus called hepatitis Delta virus<\/strong>. When this occurs, the damage to the liver is much greater, which worsens the prognosis of the disease.<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-3145b82\" data-id=\"3145b82\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-33ae7ad1 elementor-widget elementor-widget-image\" data-id=\"33ae7ad1\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/fehv.org\/wp-content\/uploads\/2018\/06\/hepatitisB-virus.jpg\" title=\"\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-62414eb elementor-widget elementor-widget-text-editor\" data-id=\"62414eb\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Hepatitis B virus seen under a microscope.<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6fb32e41 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6fb32e41\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6d9deee1\" data-id=\"6d9deee1\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-75ecd620 elementor-widget elementor-widget-shortcode\" data-id=\"75ecd620\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\"><blockquote class=\"blockquote irc-bcq\">Hepatitis B infection can be prevented with a very effective vaccine.<br><footer>Dr. Vicente Carre\u00f1o<\/footer><\/blockquote><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-32b44eec elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"32b44eec\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5c5c976\" data-id=\"5c5c976\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-79c962cd elementor-widget elementor-widget-text-editor\" data-id=\"79c962cd\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h4>Pathways of Hepatitis B infection<\/h4>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7d2a5121 elementor-widget elementor-widget-text-editor\" data-id=\"7d2a5121\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>VBH is transmitted through blood and other body fluids such as saliva and semen that may contain traces of blood. Another important route of <strong>transmission of hepatitis B<\/strong> is the vertical route from the infected mother to the child during delivery. The virus can also be transmitted from mother to child through breast milk.<\/p>\n<p>Taking into account the routes of transmission of the virus, are practices of risk performing tattoos or piercings, acupuncture, sharing syringes and objects that may have traces of blood such as toothbrushes, razors or nail clippers and maintaining relationships sexual without protection.<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4dad7b5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4dad7b5\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7175c22\" data-id=\"7175c22\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0467e64 elementor-widget elementor-widget-text-editor\" data-id=\"0467e64\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h4>Diagnosis<\/h4>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4389649 elementor-widget elementor-widget-text-editor\" data-id=\"4389649\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Most people infected acutely with the <strong>hepatitis B virus have no symptoms<\/strong>. Occasionally these people may present with yellowing of the skin (jaundice), dark urine, tiredness, loss of appetite, nausea, vomiting and abdominal pain.<\/p>\n<p><strong>The chronic infection does not produce symptoms in the majority of the cases<\/strong> and the disease usually is discovered during routine analyzes of blood when being observed that the levels of the hepatic enzymes (transaminases) are elevated. To confirm that this transaminase elevation is caused by HBV, the presence of the protein that forms the outer coat of the virus called surface antigen (HBsAg) and virus DNA (VBH-DNA) is detected in blood. Other markers of HBV infection that are detected in blood are the antibodies against the protein that forms the inner core of the virus (anti-HBc) of both IgM and IgG, another viral protein called &#8220;e&#8221; antigen (AgHBe) and the antibodies against it (anti-HBe).<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6cb39048 elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6cb39048\" data-element_type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-74345d50\" data-id=\"74345d50\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-57c6b76f elementor-widget elementor-widget-image\" data-id=\"57c6b76f\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/fehv.org\/wp-content\/uploads\/2018\/06\/medical-appointment-doctor-healthcare-40568.jpeg\" title=\"\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-17d4aedf\" data-id=\"17d4aedf\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-278daee6 elementor-widget elementor-widget-text-editor\" data-id=\"278daee6\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h4>Prevention<\/h4>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-611162b5 elementor-widget elementor-widget-text-editor\" data-id=\"611162b5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>Hepatitis B infection can be prevented by a specific vaccine<\/strong>. This vaccine is very effective and generates antibodies that protect against infection in up to 90% of the people who receive it. The protection lasts at least 20 years and it is very likely that it can protect for life although this has not been proven yet.<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-760311e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"760311e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-e940921\" data-id=\"e940921\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-563003b elementor-widget elementor-widget-text-editor\" data-id=\"563003b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h4>Treatment<\/h4>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cff676b elementor-widget elementor-widget-text-editor\" data-id=\"cff676b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>The <strong>goals of hepatitis B treatment<\/strong> are:<\/p>\n<ol>\n<li>Avoid inflammation and destruction of liver cells.<\/li>\n<li>Try to eliminate the virus (loss of VBH-DNA and HBsAg in blood).<\/li>\n<\/ol>\n<p><strong>All patients with hepatitis B and increased transaminases should be treated<\/strong>. However, 20% of patients with HBV infection have normal transaminase levels and should only be treated if they have a high viral load (levels of VBH-DNA in blood).<\/p>\n<p>There are <strong>several drugs that are useful for the treatment of hepatitis B<\/strong> virus that can be divided into two groups:<\/p>\n<ul>\n<li>Immunomodulators (Interfer\u00f3n alfa pegilado -PEG-IFN-).<\/li>\n<li>Nucleoside analogs.<\/li>\n<\/ul>\n<p>PEG-IFN is administered by a weekly subcutaneous injection and results in the normalization of transaminase levels (objective 1) in 39% of chronic hepatitis B viruses and the loss of VBH-DNA in 25% and Ag HBs in 6% of the cases (objective 2). However, PEG-IFN produces important side effects (flu syndrome, joint pain, etc).<\/p>\n<p>With respect to nucleoside analogs, they achieve normalization of transaminase levels in 40% -80% of patients (objective 1) and the loss of VBH-DNA in 40% -90% and AgHBs in 3 % -6% of cases (objective 2). Treatment with nucleoside analogues is well tolerated without significant side effects and is administered orally (one tablet per day).<\/p>\n<p>There are several nucleoside analogues currently available: Lamivudina, Adefovir, Telbivudina, Entecavir y Tenofovir.<\/p>\n<p><strong>Lamivudine<\/strong> and <strong>Adefovir<\/strong> produce resistance (mutations in the DNA of B virus that make the drug ineffective) with a frequency of 70% after 5 years of treatment, so they are generally not used.<\/p>\n<p><strong>Entecavir<\/strong> and <strong>Tenofovir<\/strong> produce hardly any resistance and are the drugs of choice. The drawback is that they must be administered for years because if the treatment is interrupted before the HBsAg is lost, most patients relapse.<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-429e7941 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"429e7941\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-14b7c8\" data-id=\"14b7c8\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5646e071 elementor-widget elementor-widget-text-editor\" data-id=\"5646e071\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h5>Most people infected acutely with the hepatitis B virus have no symptoms.<\/h5>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-28ef21f4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"28ef21f4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-764cf412\" data-id=\"764cf412\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-25dac671 elementor-widget elementor-widget-text-editor\" data-id=\"25dac671\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h4>How aggression and evolution can be predicted<\/h4>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5d389bf3 elementor-widget elementor-widget-text-editor\" data-id=\"5d389bf3\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>By means of a liver biopsy, the degree of inflammation of the liver and the level of destruction of the hepatocytes can be determined.<\/p>\n<p>In recent years it has been proven that the <strong>evolution of liver damage in chronic hepatitis B<\/strong> can be predicted by determining a polymorphism (variant) of the human PNPLA3 gene. To study this polymorphism, a puncture is performed on the patient&#8217;s fingertip (similar to that done to determine glucose levels) and the drop of blood is deposited on a special card that absorbs and preserves human DNA. The analysis can give the following results.<\/p>\n<ul>\n<li>Homozygous CC: Low risk of progression of liver damage.<\/li>\n<li>Heterozygous CG: Low risk of progression of liver damage.<\/li>\n<li>Homozygous GG: High risk of progression to more severe forms of liver damage (increased liver fibrosis).<\/li>\n<\/ul>\n<p>Other useful techniques to know <strong>the aggressiveness of liver disease in chronic hepatitis B<\/strong> are ultrasound of the liver and Fibroscan.<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-28620903 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"28620903\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-168d10d5\" data-id=\"168d10d5\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-38aedac2 elementor-widget elementor-widget-text-editor\" data-id=\"38aedac2\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h4><strong>References<\/strong><\/h4>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6c39ca32 elementor-widget elementor-widget-text-editor\" data-id=\"6c39ca32\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul>\n<li>McMahon BJ. Epidemiology and natural history of hepatitis B. Semin Liver Dis 2005;25(Suppl 1):3-8.<\/li>\n<li>Pardo M, et al. Current therapy of chronic hepatitis B. Arch Med Res 2007;38:661-77.<\/li>\n<li>Dienstag JL. Hepatitis B virus infection. N Engl J Med 2008;359:1486\u20131500.<\/li>\n<li>Gill US, Kennedy PT. New insights in the management of chronic hepatitis B. Clin Med 2015;15:191-196.<\/li>\n<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-116ae1cd elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"116ae1cd\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-1c0493d3\" data-id=\"1c0493d3\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-be5d9b5 elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"be5d9b5\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-4a5dd76a\" data-id=\"4a5dd76a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1a9ab95c elementor-widget elementor-widget-image\" data-id=\"1a9ab95c\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/fehv.org\/wp-content\/uploads\/2018\/06\/Vicente-Carreno-clinica-hepatologia.jpg\" title=\"\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-692b67bf\" data-id=\"692b67bf\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-60d95cca elementor-widget elementor-widget-text-editor\" data-id=\"60d95cca\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Consult our doctor<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-66779037 elementor-widget elementor-widget-heading\" data-id=\"66779037\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Dr. Vicente Carre\u00f1o<br>Hepatology specialist<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-70a34804 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"70a34804\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7ef44c17 elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7ef44c17\" data-element_type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-13b761f6\" data-id=\"13b761f6\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-66032d00 elementor-widget elementor-widget-heading\" data-id=\"66032d00\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">REQUEST INFORMATION WITHOUT COMMITMENT<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-18b77bec\" data-id=\"18b77bec\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2e27d27a elementor-align-center elementor-widget elementor-widget-button\" data-id=\"2e27d27a\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xl\" href=\"\/?page_id=810\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">REQUEST INFORMATION <\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9973cc2 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9973cc2\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2280e23\" data-id=\"2280e23\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-74b5150 elementor-widget elementor-widget-shortcode\" data-id=\"74b5150\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t    <div class=\"container mt-5\">\r\n        <div class=\"row\">\r\n        \r\n                <div class=\"col-sm-4 mb-5\">\r\n                    <div class=\"card shadow \">\r\n                        <img fetchpriority=\"high\" decoding=\"async\" class=\"card-img-top img-fluid\" src=\"\" width=\"300\" height=\"200\" alt=\"Card image cap\" style=\"height: 200px;\">\r\n                        <div class=\"card-body\">\r\n                            <div style=\"min-height: 180px;\">\r\n                                <h5 class=\"card-title\"><a href=\"https:\/\/fehv.org\/en\/diseases\/autoinmune-hepatitis\/\">Autoimmune hepatitis<\/a><\/h5>\r\n                                <p class=\"card-text\"><small class=\"text-muted\">It is a progressive chronic inflammatory disease of the liver that can lead to liver cirrhosis.\r\n<\/small><\/p>\r\n                            <\/div>\r\n                            <a href=\"https:\/\/fehv.org\/en\/diseases\/autoinmune-hepatitis\/\"><strong>Saber m\u00e1s<\/strong><\/a>\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n\r\n                \r\n                <div class=\"col-sm-4 mb-5\">\r\n                    <div class=\"card shadow \">\r\n                        <img fetchpriority=\"high\" decoding=\"async\" class=\"card-img-top img-fluid\" src=\"\" width=\"300\" height=\"200\" alt=\"Card image cap\" style=\"height: 200px;\">\r\n                        <div class=\"card-body\">\r\n                            <div style=\"min-height: 180px;\">\r\n                                <h5 class=\"card-title\"><a href=\"https:\/\/fehv.org\/en\/diseases\/hepatitis-c\/\">Hepatitis C<\/a><\/h5>\r\n                                <p class=\"card-text\"><small class=\"text-muted\">Hepatitis is an inflammation of the liver, and in the case of hepatitis C, caused by infection with hepatitis C virus (HCV)<\/small><\/p>\r\n                            <\/div>\r\n                            <a href=\"https:\/\/fehv.org\/en\/diseases\/hepatitis-c\/\"><strong>Saber m\u00e1s<\/strong><\/a>\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n\r\n                \r\n                <div class=\"col-sm-4 mb-5\">\r\n                    <div class=\"card shadow \">\r\n                        <img decoding=\"async\" class=\"card-img-top img-fluid\" src=\"https:\/\/fehv.org\/wp-content\/uploads\/2021\/03\/higado_graso-350x159.jpg\" width=\"300\" height=\"200\" alt=\"Card image cap\" style=\"height: 200px;\">\r\n                        <div class=\"card-body\">\r\n                            <div style=\"min-height: 180px;\">\r\n                                <h5 class=\"card-title\"><a href=\"https:\/\/fehv.org\/en\/diseases\/fatty-liver\/\">Fatty liver<\/a><\/h5>\r\n                                <p class=\"card-text\"><small class=\"text-muted\">It is the second cause of liver transplantation in the USA and in the next 10 years is expected to be the first cause. It is a serious illness if it is not treated properly.<\/small><\/p>\r\n                            <\/div>\r\n                            <a href=\"https:\/\/fehv.org\/en\/diseases\/fatty-liver\/\"><strong>Saber m\u00e1s<\/strong><\/a>\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n\r\n                \r\n                <div class=\"col-sm-4 mb-5\">\r\n                    <div class=\"card shadow \">\r\n                        <img fetchpriority=\"high\" decoding=\"async\" class=\"card-img-top img-fluid\" src=\"\" width=\"300\" height=\"200\" alt=\"Card image cap\" style=\"height: 200px;\">\r\n                        <div class=\"card-body\">\r\n                            <div style=\"min-height: 180px;\">\r\n                                <h5 class=\"card-title\"><a href=\"https:\/\/fehv.org\/en\/diseases\/hidden-infection-by-virus-c\/\">Hidden infection by C virus<\/a><\/h5>\r\n                                <p class=\"card-text\"><small class=\"text-muted\">Up to 30% of patients with cryptogenic hepatitis can be caused by the seronegative hidden infection by hepatitis C virus (HIC).<\/small><\/p>\r\n                            <\/div>\r\n                            <a href=\"https:\/\/fehv.org\/en\/diseases\/hidden-infection-by-virus-c\/\"><strong>Saber m\u00e1s<\/strong><\/a>\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n\r\n                \r\n                <div class=\"col-sm-4 mb-5\">\r\n                    <div class=\"card shadow \">\r\n                        <img fetchpriority=\"high\" decoding=\"async\" class=\"card-img-top img-fluid\" src=\"\" width=\"300\" height=\"200\" alt=\"Card image cap\" style=\"height: 200px;\">\r\n                        <div class=\"card-body\">\r\n                            <div style=\"min-height: 180px;\">\r\n                                <h5 class=\"card-title\"><a href=\"https:\/\/fehv.org\/en\/diseases\/hepatitis-cryptogenic\/\">Cryptogenic Hepatitis<\/a><\/h5>\r\n                                <p class=\"card-text\"><small class=\"text-muted\">It is a liver disease of an inflammatory nature and can develop chronically.\r\n<\/small><\/p>\r\n                            <\/div>\r\n                            <a href=\"https:\/\/fehv.org\/en\/diseases\/hepatitis-cryptogenic\/\"><strong>Saber m\u00e1s<\/strong><\/a>\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n\r\n                \r\n                <div class=\"col-sm-4 mb-5\">\r\n                    <div class=\"card shadow \">\r\n                        <img fetchpriority=\"high\" decoding=\"async\" class=\"card-img-top img-fluid\" src=\"\" width=\"300\" height=\"200\" alt=\"Card image cap\" style=\"height: 200px;\">\r\n                        <div class=\"card-body\">\r\n                            <div style=\"min-height: 180px;\">\r\n                                <h5 class=\"card-title\"><a href=\"https:\/\/fehv.org\/en\/diseases\/cholangitis\/\">Cholangitis<\/a><\/h5>\r\n                                <p class=\"card-text\"><small class=\"text-muted\">It is a chronic progressive liver disease that mainly affects women (90% of cases) from the fourth decade of life.<\/small><\/p>\r\n                            <\/div>\r\n                            <a href=\"https:\/\/fehv.org\/en\/diseases\/cholangitis\/\"><strong>Saber m\u00e1s<\/strong><\/a>\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n\r\n                \r\n        <\/div>\r\n        <div class=\"row\">\r\n            <div class=\"col text-center\">\r\n                <a class=\"text-primary font-weight-bold\" href=\"https:\/\/fehv.org\/enfermedades\/\" target=\"_self\">Ver todas<\/a>\r\n            <\/div>\r\n        <\/div>\r\n    <\/div>\r\n\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"It is a viral infection of the liver that causes inflammation of the liver and the death of hepatocytes.","protected":false},"author":1,"featured_media":0,"parent":1586,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-1602","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v23.7 (Yoast SEO v23.7) - 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