Hepatitis B: Epidemiology and prevention in developing countries

Abstract

Hepatitis B virus (HBV) infection is a serious global public health problem. The infection may be transmitted through sexual intercourse, parenteral contact or from an infected mother to the baby at birth and, if contracted early in life, may lead to chronic liver disease, including cirrhosis and hepatocellular carcinoma. On the basis of the HBV carrier rate, the world can be divided in 3 regions of high, medium and low endemicity. The major concern is about high endemicity countries, where the most common route of infection remains vertical transmission from mother to child. Screening of all pregnant women and passive immunization with human hepatitis B immunoglobulin are not affordable for many developing countries. The infection rate can be reduced by modifying behavior, improving individual education, testing all blood donations, assuring asepsis in clinical practice and screening all pregnant women. However, availability of a safe and efficacious vaccine and adoption of appropriate immunization strategies are the most effective means to prevent HBV infection and its consequences. The unsolved problem for poorest countries, where the number of people currently infected is high, is the cost of the vaccine. A future challenge is to overcome the social and economic hurdles of maintaining and improving a prevention policy worldwide to reduce the global burden of the disease.

Hepatitis B Vaccination among Primary Health Care Workers in Northwest Pakistan

“…(7) Occupational exposure to blood and body fluids places healthcare workers at risk of infection with blood borne viruses including hepatitis B, hepatitis C, and HIV. (5) The risk of getting HBV infection by HCWs is four fold higher as opposed to adult general population. (8) Also, the risk of contracting HBV infection in an unvaccinated person from an HBV-infected needle stick or sharp injury ranges from 6-30%.…”

“…(4) The hepatitis B vaccine's effectiveness and safety have been rigorously documented: 95-100% of children and 90-95% of healthy young adults receiving the full 3-dose series develop protective antibodies. (5,6) The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis B vaccine for everyone 18 years of age and younger as well as for adults over 18 years of age who are at risk of hepatitis B infection. Adults who are at increased risk of infection and who should receive vaccination include: sexually active heterosexual adults with more than one sex partner in the prior 6 months or a history of sexually transmitted disease; men who had sex with men; illicit injection drug users, hemodialysis patients and persons at occupational risk of infection.…”

Enteric trimethyl chitosan nanoparticles containing hepatitis B surface antigen for oral delivery

“…1 Chronic HB disease induces persistent hepatitis, liver cirrhosis, and hepatic malignancy. Approximately 30% of the world's population has been infected with HBV and 350 million are persistent carriers.…”

Epidemiology of hepatitis B virus infection among recyclable waste collectors in central Brazil

“…HBV infection can be transmitted through unprotected sexual intercourse, contact with contaminated blood or motherto-child transmission, and this infection can lead to chronic liver disease, which affects more than 240 million individuals worldwide. Chronic carriers constitute a potential reservoir of HBV and are at increased risk of developing liver cirrhosis or hepatocellular carcinoma 1,2 .…”