Hepatitis B Virus medical comic
This comic decodes hepatitis B, starting with the Dane particle and its decoy particles. It walks through the serological markers of acute, chronic, past and vaccine-induced immunity, explains the window period, covers hepatitis D and extrahepatic disease, then treatment and preventing mother-to-child transmission, with NEET-PG and USMLE practice cases.
For MBBS, NEET-PG, FMGE, NEXT and USMLE revision.
Hepatitis B: what the comic covers
High-yield points
- The complete virion is the 42 nm Dane particle; far more numerous 22 nm spheres and filaments contain no DNA and act as decoys that soak up antibodies.
- HBsAg is the first marker to appear; HBsAg persisting for more than 6 months means chronic infection.
- Anti-HBc IgM marks acute infection; HBeAg indicates active replication and high infectivity.
- In the window period HBsAg has gone but anti-HBs has not yet appeared, so anti-HBc IgM is the only positive marker.
- Anti-HBs indicates immunity; a vaccinated person has anti-HBs alone, while past natural infection also shows anti-HBc.
- Hepatitis D virus is defective and needs the HBV surface coat (HBsAg) to leave cells and infect new ones; co-infection or superinfection worsens liver disease.
- Polyarteritis nodosa linked to HBV is a type III hypersensitivity from HBsAg–antibody immune complexes in medium-sized arteries.
- Treatment uses nucleos(t)ide analogues such as tenofovir and entecavir, or interferon; babies of infected mothers need hepatitis B vaccine and HBIG within 12 hours of birth at separate sites.
Quick questions
What is the window period in hepatitis B?
The gap after HBsAg disappears and before anti-HBs appears. Both are negative, so anti-HBc IgM is the only marker that shows the infection.
How do you tell vaccination from past infection on hepatitis B serology?
A vaccinated person is positive only for anti-HBs. A person who recovered from natural infection is positive for both anti-HBs and anti-HBc.
How is hepatitis B passed from mother to baby prevented?
The newborn receives hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) within 12 hours of birth, injected at separate sites, then completes the vaccine schedule. Antiviral treatment in late pregnancy is added when the mother's viral load is high.
Is this comic free to read?
The first pages are free to preview. Members read the full comic, and you can sign up free to read one comic in full.
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