Table 3.

Suggested Evaluation of inmates with chronic hepatitis B

Initial evaluation
Clinical	1. Medical/family history: Determine potential risk exposures
	2. Physical examination: Look for signs of cirrhosis (ascites, edema, gynecomastia, palmar erythema, spider angiomas)
Biochemical	CBCa, LFTs, Coagulation profile, Creatinine.
Serological	HBe antigen/antibody, HBV DNA, HBV-genotypeb
Coinfection screening	Antibodies against HIV, HCV, HAV
Complication screening	AFP, liver ultrasoundb (if AFP or clinical suspicion high)
Histopathological	Liver biopsyb
Follow-up evaluation for those on treatment
Clinical (Q 3 months)	1. Physical examination: Look for signs of worsening liver disease/cirrhosis.
	2. Counseling to avoid risk behavior, and encourage medication adherence.
Biochemical	CBCa, LFTs every 3 months, Coagulation profile every 6 months
Serological (Q 3–6 months)	HBV DNA, HBe Antigen/Antibody if HBeAntigen positive hepatitis
Radiological	Liver ultrasoundb (if sudden decompensation occurs)
Follow-up evaluation for those not on treatment (initially did not qualify for treatment)
Clinical (Q 3 months)	1. Physical examination: Look for signs of worsening liver disease/cirrhosis
	2. Counseling to avoid risk behavior
Biochemical	LFTs every 3–6 months, if were normal initially.
Serological	HBV DNA every 6 months, if was low initially.
Radiological	Liver ultrasoundb (if Sudden decompensation occurs)

CBC complete blood count, LFTs liver function tests, HBV DNA hepatitis B virus deoxynucleic acid, HIV human immunodeficiency virus, HCV hepatitis C virus, HAV hepatitis A virus, AFP alpha fetoprotein, Q every

^aPlatelet count should especially be monitored in CBC profile

^bOptional, depending on clinical judgment. Generally recommended by AASLD guidelines