213.2 📚 國考版

213.2.0.1 必背 — HBV Markers

Marker Meaning
HBsAg Current infection
Anti-HBs Immunity (vaccine or recovery)
HBeAg Active replication
Anti-HBe Lower replication
Anti-HBc IgM Acute
Anti-HBc IgG Past/chronic
HBV DNA Viral load

213.2.0.2 必背 — Chronic Risk by Age

  • Perinatal: 90%+ chronic
  • Childhood (1-5 yr): 30-50%
  • Adult: 5-10%

213.2.0.3 必背 — High-Risk Regions

  • Sub-Saharan Africa, E + SE Asia (Taiwan, China, Korea, Vietnam)

213.2.0.4 必背 — Phases of Chronic HBV

  • Immune tolerant
  • Immune active (HBeAg+)
  • Inactive carrier
  • Reactivation (HBeAg-)

213.2.0.5 必背 — Treatment First-Line

  • TAF, TDF, Entecavir
  • Peg-IFN limited use
  • Lifelong typically

213.2.0.6 必背 — HBV Reactivation Risk

  • Anti-CD20 (rituximab) highest
  • High-dose steroids, chemo, transplant, anti-TNF
  • Prophylaxis required with antiviral
  • HBcAb+ HBsAg- can reactivate (occult)

213.2.0.7 必背 — Vertical Prevention

  • Tenofovir 3rd trimester if HBV DNA > 200K IU/mL
  • Birth-dose vaccine + HBIG within 12 hr
  • < 5% vertical with combination

213.2.0.8 必背 — HCC Surveillance

  • Cirrhotic + high-risk Asian/African
  • Liver US + AFP q6 months

213.2.0.9 必背 — Vaccine

  • 3-dose recombinant

  • 95% efficacy

  • Universal childhood + adults 19-59 (2022 update)

213.2.0.10 必背 — HBV Cure Therapeutics (2024-2025)

  • Bulevirtide, GalNAc-siRNA, capsid assembly modulators, therapeutic vaccines
  • Goal: functional cure (HBsAg loss)