APP Roundtable: Challenges in Diagnosing CHB

Join physician assistants Helen Adams, Mount Sinai Medical Center, and Emily Przybyl, Erie County Medical Center, as they dive into the clinical complexities of chronic hepatitis B in this insightful discussion. With over 250 million people living with chronic hepatitis B worldwide, the episode emphasizes the urgency of early diagnosis, proper screening, and effective long-term monitoring to prevent progression to cirrhosis and hepatocellular carcinoma (HCC). Helen and Emily review the importance of comprehensive hepatitis B triple panel testing (surface antigen, surface antibody, core antibody), the nuances of interpreting serologies, and updated screening guidelines for high-risk populations—including pregnant women, individuals born in endemic regions, and immunocompromised patients. They also address the role of non-invasive tools like FibroScan in staging fibrosis, the risk of HBV reactivation in patients undergoing immunosuppressive therapy, and pitfalls with newer HIV regimens that lack HBV suppression. With practical advice, clinical anecdotes, and references to AASLD and AGA guidelines, this episode provides a must-hear overview for clinicians managing hepatitis B in diverse patient populations.