Hepatitis B (HBV) is a chronic viral infection that can lead to liver cirrhosis, failure, or cancer if untreated. Direct Primary Care (DPC)—a membership-based model with flat monthly fees—provides continuous, coordinated care to suppress the virus, prevent complications, and empower patients through personalized management aligned with American Association for the Study of Liver Diseases (AASLD) guidelines.
Transmission: Blood/body fluids (unprotected sex, shared needles, mother-to-child).
Phases:
Immune-Tolerant: High viral load, minimal liver damage (common in younger patients).
Immune-Active: Elevated liver enzymes, active inflammation.
Inactive Carrier: Low viral load, no significant damage.
Complications: Cirrhosis, hepatocellular carcinoma (HCC), liver failure.
Diagnosis: Blood tests (HBsAg, HBV DNA, ALT), FibroScan®, ultrasound.
Same-Day Testing: Confirm HBV with HBsAg and HBV DNA testing during initial visits.
Fibrosis Assessment: Coordinate FibroScan® or elastography to evaluate liver damage.
First-Line Medications: Prescribe entecavir or tenofovir (TAF/TDF) to suppress HBV DNA.
Monitoring: Track viral load every 3–6 months to ensure undetectable levels.
Vaccination: Administer HBV vaccines to household members, sexual partners, and at-risk contacts.
Cancer Surveillance: Biannual liver ultrasounds + AFP tests for early HCC detection.
Regular Monitoring: Frequent liver function tests, HBV DNA levels, and HCC screening per AASLD guidelines.
Lifestyle Counseling: Guide alcohol cessation, metabolic syndrome management, and nutrition plans to slow disease progression.
24/7 Telehealth: Address medication side effects (e.g., kidney concerns with TDF) promptly.
Timely Interventions: Same-day appointments ensure rapid adjustments to treatment plans.
Flat Monthly Fees ($100–$200): Cover exams, care coordination, and basic labs—no hidden bills.
Medication Savings: Negotiate discounted generics (e.g., entecavir for $30/month).
Watchful Waiting: Delay antivirals while monitoring ALT/HBV DNA every 6 months.
Family Screening: Test and vaccinate household members to prevent transmission.
Antiviral Initiation: Start entecavir/tenofovir to reduce viral load and inflammation.
Resistance Prevention: Avoid older antivirals (e.g., lamivudine) to minimize resistance risks.
Portal Hypertension Management: Prescribe propranolol to reduce variceal bleeding risk.
Specialist Coordination: Partner with hepatologists for endoscopic variceal screening.
After John’s HBV diagnosis, his DPC provider:
Prescribed tenofovir alafenamide (TAF) to suppress HBV DNA.
Monitored his viral load quarterly, achieving undetectable levels in 9 months.
Coordinated biannual liver ultrasounds, detecting a small HCC tumor early.
John underwent curative resection and remains cancer-free 5 years later.
Q: Can DPC cure Hepatitis B?
A: No—HBV is managed, not cured. DPC focuses on suppressing the virus and preventing complications.
Q: Are antivirals safe long-term?
A: Yes. DPC monitors kidney function (for TDF) and bone density to ensure safety.
Q: How often is HCC screening needed?
A: Every 6 months for high-risk patients (cirrhosis, family history of liver cancer).
Q: Can I drink alcohol with HBV?
A: Avoid alcohol completely—DPC provides resources for cessation support.
Guideline Adherence: Follows AASLD protocols for antiviral therapy, monitoring, and HCC screening.
Early Intervention: Prevents cirrhosis through timely viral suppression.
Patient Empowerment: Educates on transmission prevention (safe sex, needle hygiene) and lifestyle changes.
Cost Transparency: Affordable access to generics, imaging, and specialists without insurance hurdles.
Take Charge of Your Liver Health with DPC
Hepatitis B requires vigilant, lifelong care—but with DPC, you gain a partner dedicated to personalized, proactive management. From routine monitoring to cutting-edge treatments, DPC ensures you stay ahead of HBV and live your healthiest life.
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