HEPATITIS / YOUNOSSI
Hepatitis B
Epidemiology. Between 1988 and 1994 (NHANES III), the prevalence of
serologic markers of HBV infection was 4.9%, while the prevalence of
chronic HBV infection was 0.4%. In the past 2 decades, the actual rate of
HBV infection in the US is estimated at approximately 300,000 cases per
year.16,17 Since 1987, the actual incidence of HBV has declined by 70%.
Approximately 200 to 300 deaths occur annually due to hepatitis B.6,18,19
Infection occurs primarily in young adults because of lifestyle or
occupational exposure.17 A recent report of a large-scale screening
program for viral hepatitis revealed that the prevalence of infection with
the hepatitis B virus (HBV) in the sampled cohort was 17.8%, with
hepatitis B disease present in 0.7% of the overall US population.20
Hepatitis B virus is a small, double-stranded member of the Hepadnaviridae family of hepatotropic DNA viruses (Table 1).10,11 Hepatitis B virus replicates in hepatocytes but is secreted and maintained in extrahepatic sites, including blood, saliva, and other body fluids. The virus is transmitted parenterally, by sexual contact, and perinatally. Transfusion-associated HBV has become rare in the US since routine screening of the blood supply has been in place. Risk factors continuing to be associated with HBV infection include hemodialysis, intravenous (IV) drug use, sex with an IV drug user,20,21 as well as unsafe injection practices, tattooing, and body piercing.22–25 The majority of HBV surface antigen (HBsAg)-positive mothers with active HBV infection (ie, HBV e antigen [HBeAg]-positive) will transmit the disease to their offspring; HBsAg-positive asymptomatic carriers with anti-HBe antibodies (HBeAg-negative) do so less frequently (10% to 15%).26–28
Cleveland Clinic Journal of Medicine
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