National case definition: Hepatitis B

Hepatitis B

Date of last revision/review: May 2008

National notification

The following cases of disease should be notified:

• Confirmed acute
• Although it is recognized that chronic hepatitis B infections are not reportable in all provinces and territories, where possible, chronic and unspecified infections should be notified to the national level.

Type of surveillance

Routine case-by-case notification to the federal level

Case classification

• Acute case
  • Confirmed case
    • Hepatitis B surface antigen (HBsAg) and immunoglobulin M antibody to hepatitis B core antigen (anti-HBcIgM) positive in the context of a compatible clinical history or probable exposure
  • or
    • Clearance of HBsAg in a person who was documented to be HBsAg positive within the last six months in the context of a compatible clinical history or probable exposure
  • Probable case
    Acute clinical illness in a person who is epidemiologically linked to a confirmed case
• Chronic carrier
  • Confirmed case
    • HBsAg positive for more than 6 months
  • or
    • Detection of HBsAg in the documented absence of anti-HBc-IgM
  • or
    • Detection of HBV DNA for more than 6 months
• Unspecified
  • Confirmed case
    • Does not fit the criteria for either case above
  • and
    • HBsAg positive
  • or
    • Detection of HBV DNA

Laboratory comments

Occult HBV infection is characterized by a positive HBV DNA and presence of anti-HBc alone or anti-HBc and anti-HBs in the absence of HBsAg.

Further isolate characterization is indicated for epidemiologic public health and control purposes.

Clinical evidence

Acute clinical illness is characterized by a discrete onset of symptoms and jaundice or elevated serum aminotransferase levels. Chronic infections may present with disease flares with similar symptoms and signs.

ICD code(s)

• ICD-10 code(s)
  • B16 Acute hepatitis B
  • B16.0 Acute hepatitis B with delta-agent (coinfection) with hepatic coma
  • B16.1 Acute hepatitis B with delta-agent (coinfection) without hepatic coma
  • B16.2 Acute hepatitis B without delta-agent with hepatic coma
  • B16.9 Acute hepatitis B without delta-agent and without hepatic coma
  • Hepatitis B (acute) (viral) NOS
  • B18.0, Chronic viral hepatitis B with delta-agent
  • B18.1 Chronic viral hepatitis B without delta-agent
• ICD-9 code(s)
  • 070.30 Hepatitis B (acute)
  • 070.20 Hepatitis B (acute) with hepatic coma
  • 070.21/31 Hepatitis B (acute) with hepatitis delta
  • V02.61 Hepatitis B (carrier status)
  • 070.32 Hepatitis B (chronic)
  • 070.22 Hepatitis B (chronic) with hepatic coma
  • 070.23 Hepatitis B (chronic) with hepatitis delta

References

Public Health Agency of Canada. Case Definitions for Communicable Diseases under National Surveillance. Canada Communicable Disease Report. 2009; 35S2.