![]() CHB is often asymptomatic and may go undetected for many years. Chronic infection is defined by the presence of HBsAg in the blood for more than 6 months and in the majority of cases, chronic infection is lifelong. ![]() When HBV is transmitted from mother to child (at birth) or horizontally in early childhood, the majority ~ 90% will develop chronic hepatitis B (CHB) infection. In a small proportion of adults ~ 5%, chronic HBV can develop. Adult infection is associated with a robust immune response in the majority of cases (>95%), which can clear the virus from the body leading to resolved HBV infection. The majority of HBV infections in adulthood lead to an acute illness, which lasts for less than 6 months. While many of the symptoms associated with acute HBV are similar to those of “flu”, the development of jaundice (yellowing of the skin or whites of the eyes) and the presence of dark urine should raise the suspicion of acute viral hepatitis. Fever, general malaise, weakness, fatigue and in a proportion, joint pains. HBV can cause of acute viral Hepatitis and the following signs and symptoms can be present abdominal pain, loss of appetite, nausea and vomiting. Notably, in recent years prevalence in individual countries appears to be influenced by migration patterns with immigrants accounting for 95% of new diagnoses of HBV infections in many developed countries. However, in Western Europe and North America <1% of the adult population is chronically infected. Prevalence rates of CHB infection vary widely, from 5-10% in high endemic areas such as sub-Saharian Africa, East Asia, the Amazon and the Southern regions of Eastern and Central Europe. In high prevalence regions, the majority of HBV infections are through vertical (or perinatal) transmission, which means the spread of HBV from an infected mother to her child at birth or around the time of birth. Direct contact with the blood or open sores of an infected individual or similarly the exposure to blood from needlesticks or other “sharp injuries” from an infected individual can result in transmission. ![]() HBV is transmitted through blood and body fluids, therefore it can be transmitted through sexual contact, sharing of needles, syringes or other drug paraphernalia, but also tooth brushes and razors. ![]()
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