The principle ways of spreading the hepatitis B virus include intimate contact with infected people or exposure to body fluids from these individuals by contact with infectious blood, semen, and other body fluids, primarily by birth to an infected mother, sexual contact with an infected person, sharing of contaminated needles, syringes or other injection drug equipment, and needle sticks or other sharp instrument injuries.
Some adults and children will be symptomatic (30-50%). Acute illness is rarely fatal and most will recover with no lasting liver damage. However, there is a potential for chronic infection (>90% of infants, 25-50% of children 1-5 years of age, 6-10% of older children and adults).
15%–25% of the chronically infected people will develop chronic liver disease, including cirrhosis, liver failure, or liver cancer.
Maryland has a childhood vaccination mandate for Hepatitis B. Children are required to obtain the vaccination prior to entry into daycare/elementary school. The vaccine confers long-term protection against clinical illness and chronic Hepatitis B virus infection. Studies indicate that immunologic memory remains intact for at least 20 years among healthy vaccinated individuals who initiated Hepatitis B vaccination >6 months of age. Cellular immunity appears to persist even though antibody levels might become low or decline below detectable levels.
Testing is recommended for:
•All pregnant women
• Persons born in regions with intermediate or high rates of Hepatitis B (HBsAg prevalence of ≥2%)
• U.S.–born persons not vaccinated as infants whose parents were born in regions with high rates of Hepatitis B (HBsAg prevalence of ≥8%)
• Infants born to HBsAg-positive mothers
• Household, needle-sharing, or sex contacts of HBsAg-positive persons
• Men who have sex with men
• Injection drug users
• Patients with elevated liver enzymes (ALT/AST) of unknown etiology
• Hemodialysis patients
• Persons needing immunosuppressive or cytotoxic therapy
• HIV-infected persons
• Donors of blood, plasma, organs, tissues, or semen
MD Form DHMH 4677:
Hepatitis B Screen: to detect acute or chronic HBV infections. (Hepatitis B surface antigen)
Hepatitis B panel: to detect acute/chronic HBV infections as well as immunity status. (Hepatitis B surface antigen, Hepatitis B surface antibody)
Hepatitis B post: to determine the patient’s immunity status. (Hepatitis B surface antibody)