Download -An estimated 240 million people are chronically infected with

-An estimated 240 million people are chronically infected with hepatitis B (defined as .
hepatitis B surface antigen positive for at least 6 months) . More than 686 000 people die
every year due to complications of hepatitis B, including cirrhosis and liver cancer.Hepatitis B
is an important occupational hazard for health workers. However, it can be prevented by
currently available safe and effective vaccine
A vaccine against hepatitis B has been available since 1982. The vaccine is 95% effective in
preventing infection and the development of chronic disease and liver cancer due to
.hepatitis B
Symptoms
Most people do not experience any symptoms during the acute infection phase. However,
some people have acute illness with symptoms that last several weeks, including yellowing
of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal
pain. A small subset of persons with acute hepatitis can develop acute liver failure which can
.lead to death
In some people, the hepatitis B virus can also cause a chronic liver infection that can later
.develop into cirrhosis of the liver or liver cancer
?Who is at risk for chronic disease
The likelihood that infection becomes chronic depends upon the age at which a person
becomes infected. Children less than 6 years of age who become infected with the hepatitis
.B virus are the most likely to develop chronic infections
In infants and children:80-9-% of infants infected during the first year of life develop chronic
infections; and 30-50% of children infected before the age of 6 years develop chronic
infections
In adults:less than 5% of otherwise healthy persons who are infected as adults will develop
chronic infection; and20-30%of adults who are chronically infected will develop cirrhosis
and/or liver cancer
Diagnosis : It is not possible, on clinical grounds, to differentiate hepatitis B from hepatitis
caused by other viral agents and, hence, laboratory confirmation of the diagnosis is
.essential
Acute HBV infection is characterized by the presence of HBsAg and immunoglobulin M (IgM)
antibody to the core antigen, HBcAg. During the initial phase of infection, patients are also
seropositive for hepatitis B e antigen (HBeAg). HBeAg is usually a marker of high levels of
replication of the virus. The presence of HBeAg indicates that the blood and body fluids of
the infected individual are highly contagious
Chronic infection is characterized by the persistence of HBsAg for at least 6 months (with or
without concurrent HBeAg). Persistence of HBsAg is the principal marker of risk for
.developing chronic liver disease and liver cancer (hepatocellular carcinoma) later in life
SO Case definition of hepatitis B: An acute illness that includes malaise, extreme fatigue,
fever, nausea and sometimes vomiting and upper right quadrant abdominal tenderness,
then dark urine followed by jaundice
:Case classification
Suspected case: A case compatible with clinical description *
Probable case: A Suspected Case + Positive Bile pigment in urine and elevated serum *
)bilirubin and liver enzymes (ALT, SGPT and Serum Alkaline Phosphatase
Confirmed case: Probable/suspected case with positive specific serological tests. This can *
be done by different methods and the most famous one is ELISA method. In addition great
increase of liver enzymes like alanine transaminase (ALT), serum alkaline phosphatase and
.SGOT etc
Occurrence
In countries where HBV is highly endemic (HBs Ag prevalence 8% or higher), most infection
.occur during infancy & early childhood
in countries where HBV is intermediately endemic (HBs Ag prevalence 2-7%) & occur in all
.age group
In countries with low endemicity (HBs Ag prevalence less than 2%), most infection occur in
young adult especially high risk group
Iraq is considered with low endemic with HBsAg prevalence was 1.6% in 2006