Epidemiology of hepatitis B in Europe and worldwide
Introduction
Hepatitis B virus (HBV) infection is a major public health problem and cause of infectious disease mortality worldwide. Approximately 2 billion people – one third of the world's population – have serologic evidence of past or present HBV infection, and 350 million people are chronically infected. Each year over 1 million people die from HBV-related chronic liver disease, including cirrhosis and hepatocellular carcinoma (HCC) [1]. HCC is one of the most common cancers worldwide, and HBV is responsible for at least 75% of these cancers [2].
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Geographic patterns of transmission
The endemicity of HBV infection varies greatly worldwide [3], [4] and is influenced primarily by the predominant age at which infection occurs (Table 1). Endemicity of infection is considered high in those parts of the world where at least 8% of the population is hepatitis B surface antigen (HBsAg)-positive. In these areas, 70–90% of the population generally have serological evidence of previous HBV infection. Almost all infections occur during either the perinatal period or early in childhood
Modes of transmission
The incubation period of hepatitis B is long, ranging from 45 to 160 days (average 120). HBV is transmitted by percutaneous and mucous membrane exposures to infectious blood and body fluids that contain blood. Although HBsAg has been detected in a wide variety of body fluids, only serum, semen, and saliva have been demonstrated to be infectious [5], [6]. The presence of hepatitis B e antigen (HBeAg) in serum correlates with higher titers of HBV (up to 109 particles/ml) and greater infectivity
Current epidemiology
In most developed countries, including those in northern and western Europe, the highest incidence of acute hepatitis B is among young adults, and high-risk sexual activity and injecting drug use account for most cases of newly acquired hepatitis B [36], [37], [38], [39]. However, even in these low HBV endemic countries, a substantial number of children become infected with HBV, many of whom belong to families that have immigrated from high HBV endemic countries [3], [40], [41]. Since over 90%
Prevention
The primary goal of hepatitis B prevention programs is reduction of HBV-related chronic liver disease and chronic HBV infection. A secondary goal is the prevention of acute hepatitis B. HBV infection can be prevented by screening blood, plasma, organ, tissue, and semen donors, virus inactivation of plasma-derived products, risk-reduction counseling and services, and implementation and maintenance of infection control practices. Although such activities can reduce or eliminate the potential risk
References (87)
Global programme for control of hepatitis B infection
Vaccine
(1995)- et al.
Clinical and serological analysis of transfusion-associated hepatitis
Lancet
(1975) - et al.
Nosocomial hepatitis B virus infections in cardiac transplant recipients transmitted during transvenous endomyocardial biopsy
J Hosp Infect
(1994) - et al.
An outbreak of hepatitis B from tattooing
Lancet
(1979) - et al.
Survival of hepatitis B virus after drying and storage for 1 week
Lancet
(1981) - et al.
The emergence of hepatitis B as a sexually transmitted disease
Med Clin N Am
(1990) - et al.
From hepatitis B to hepatitis A and B prevention: the Puglia (Italy) experience
Vaccine
(2000) - et al.
Changing epidemiology of parenterally transmitted viral hepatitis: results from the hepatitis surveillance system in Italy
Digest Liver Dis
(2001) - et al.
Interruption of hepatitis B transmission by modification of a gynaecologist's surgical technique
Lancet
(1982) - et al.
and dental personnel: transmission to patients and prevention issues
J Am Dent Assoc
(1983)
Hepatitis B from doctors [letter]
Lancet
infections after gynaecological surgery
Lancet
Acute viral hepatitis B, reported to the Public Health Laboratory Service
J Infect
Cluster of hepatitis B transmitted by a physician
Lancet
Deja vu: nosocomial hepatitis B virus transmission and fingerstick monitoring
Am J Med
Evaluation of the hepatitis B antenatal screening and neonatal immunization program in Amsterdam, 1993–1998
Vaccine
Rationale for the infant and adolescent vaccination programmes in Italy
Vaccine
Hepatitis B epidemiology in Poland, Central and Eastern Europe and the Newly Independent States
Vaccine
Hepatitis B virus. The major etiology of hepatocellular carcinoma
Cancer
Hepatitis B: evolving epidemiology and implications for control
Semin Liver Dis
Viral hepatitis
Transmission of hepatitis B to chimpanzees by hepatitis B surface antigen-positive saliva and semen
Infect Immun
Transmission of hepatitis B virus to gibbons by exposure to human saliva containing hepatitis B surface antigen
J Infect Dis
Type B hepatitis: the infectivity of blood positive for e antigen and DNA polymerase after accidental needlestick exposure
N Engl J Med
‘e’ antigen, Dane particles and serum DNA polymerase activity in HBsAg carriers
Ann Intern Med
Hepatitis Be antigen and infectivity of hepatitis B virus
J Infect Dis
Transmission of hepatitis B to patients from four infected surgeons without hepatitis B e antigen
N Engl J Med
VA cooperative study of post-transfusion hepatitis, 1969–1974: incidence and characteristics of hepatitis and responsible risk factors
Am J Med Sci
Injections given in healthcare settings as a major source of acute hepatitis B in Moldova
Int J Epidemiol
Multiple-dose vial associated with transmission of hepatitis B virus in a hemodialysis unit
Ann Intern Med
Nosocomial transmission of hepatitis B virus associated with a spring-loaded fingerstick device
N Engl J Med
An outbreak of hospital-acquired hepatitis B virus infection among patients receiving chronic hemodialysis
Infect Control Hosp Epidemiol
An outbreak of severe hepatitis due to delta and hepatitis B viruses in parenteral drug abusers and their contacts
N Engl J Med
Prevention of hepatitis B virus infection among health care workers
A large outbreak of acupuncture-associated hepatitis B
Am J Epidemiol
HBeAg and anti-HBe detection by radioimmunoassay. Correlation with vertical transmission of hepatitis B virus in Taiwan
J Med Virol
Lack of transmission of hepatitis B to humans after oral exposure to hepatitis B surface antigen-positive saliva
MMWR
virus in a cardiopulmonary resuscitation training course
Arch Intern Med
Prevention of perinatal acquisition of hepatitis B virus carriage using vaccine: preliminary report of a randomized double-blind placebo-controlled and comparative trial
Pediatrics
Postnatal infectivity of hepatitis B surface antigen-carrier mothers
J Infect Dis
Hepatitis B infection among children born in the United States to southeast Asian refugees
New Engl J Med
Horizontal transmission of hepatitis B virus infection to United States-born children of among refugees
Pediatrics
The epidemiology of hepatitis B virus among family members in the Middle East
Am J Epidemiol
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