from Section III - Hepatitis and Immune Disorders
Published online by Cambridge University Press: 19 January 2021
Hepatitis B virus (HBV) infection continues to be a major global health problem [1]. HBV infection may cause acute, fulminant, or chronic hepatitis, cirrhosis and liver cancer. Although complications occur mainly during adult life, most primary HBV infection occurs during early childhood [1]. To control HBV infection and its complications, it is mandatory to understand the transmission mode and natural history starting from childhood. The age of primary infection is an important factor affecting the outcome. HBV infection during infancy and early childhood leads to high rates of persistent infection. Perinatal transmission from hepatitis B surface antigen (HBsAg) carrier mothers to their infants is an important route of transmission leading to chronicity in endemic areas. Before the era of universal HBV vaccination, perinatal transmission accounted for 40–50% of HBsAg carriers in Asia. Maternal HBsAg and hepatitis B e antigen (HBeAg) status affect the outcome of HBV infection in their infants. Around 90% of infants of HBeAg seropositive carrier mothers become HBsAg carriers. Horizontal transmission from highly infectious family members, improperly sterilized syringes or other contaminated instruments may also occur. HBV vaccination is the most effective way to prevent HBV infection and its complications. Despite the availability of HBV vaccine leading to decreasing incidence of HBV infections, WHO estimates that in 2015, 257 million people were living with chronic HBV infection [2].
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