ETIOLOGIC AGENT

INCIDENCE

SEQUELAE

PREVALENCE

COSTS

TRANSMISSION

RISK GROUPS

SURVEILLANCE

TRENDS

PREVENTION

• Jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, vomiting

• Hepatitis B virus

• 140,000-320,000 infections/yr in United States
• 70,000-160,000 symptomatic infections/yr

• Of symptomatic infections, 8400-19,000 hospitalizations/yr and 140-320 (0.2%) deaths/yr;
• Of all infections, 8,000-32,000 (6%-10%) chronic infections/yr, and 5,000-6,000 deaths/yr from chronic liver disease including primary liver cancer

• Estimated 1-1.25 million chronically infected Americans

• Estimated $700 million (1991 dollars)/yr (medical and work loss)

• Bloodborne
• sexual
• perinatal

• Injection drug users
• Sexually active heterosexuals
• Homosexual men
• Infants/children of immigrants from disease-endemic areas

• Low socioeconomic level
• Sexual/household contacts of infected persons
• Infants born to infected mothers
• Health care workers
• Hemodialysis patients

• National Notifiable Diseases Surveillance System
• Viral Hepatitis Surveillance Program
• Sentinel Counties Studies

Incidence increased through 1985 and then declined 55% through 1993 because of wider use of vaccine among adults, modification of high-risk behaviors, and possibly a decrease in the number of susceptible persons. Since 1993, increases observed among the three major risk groups: sexually active heterosexuals, homosexual men, and injection drug users.

• Hepatitis B vaccine available since 1982
• Screening pregnant women and treatment of infants born to infected women
• Routine vaccination of infants and 11-12 year olds
• Catch-up vaccination of high-risk groups of all ages
• Screening of blood/organ/tissue donors