Hepatitis B remains a significant yet preventable health issue in South Africa. The introduction of the hepatitis B vaccine into the country
some 18 years ago has demonstrated benefit, but the exposure to, and prevalence of chronic HBsAg positivity remain unacceptably high.
Those with chronic hepatitis B virus infection have an elevated risk of developing cirrhosis with end-stage liver disease and a markedly
elevated risk of hepatocellular carcinoma, independent of the presence of cirrhosis.
The challenge in South Africa remains prevention through the universal vaccination coverage of all children and the identification of
those with chronic hepatitis B virus infection. Over the last decade our understanding of hepatitis B and its behaviour and natural history in
those with chronic infection has significantly improved. This understanding is key to identifying those who warrant further evaluation and
therapy. A number of global societies have updated their guidelines in recent years. This document draws on these guidelines and serves to
contextualise, for South Africa, practice guidelines for the management of chronic hepatitis B.