Hepatitis B Vaccination

Wanke-Rytt Monika & Kuchar Ernest
Clinical Context
Hepatitis is an inflammation of the liver and viral infections are the most common causes of hepatitis worldwide. There are five main hepatitis viruses, A, B, C, D and E. Three of them HAV, HBV and HDV are vaccine-preventable infections. Hepatitis B is the most common viral infection of the liver. It is estimated that over 2 billion people worldwide had contracted with the virus (i.e. they have positive serological markers of infection, of which 240 million are chronically infected and 786 000 die annually due to infection) (1,2,3). The virus is transmitted through contact with the blood or body fluids of an infected person. The routes of HBV transmission include unprotected sex (vaginal, anal and oral) and vertical (usually at birth); the virus can also be spread through blood through sharing needles syringes, or other drug-injection equipment, sharing items such as razors or toothbrushes with an infected person, during procedures that breach the continuity of skin or mucous membranes (e. g. injection, taking blood samples, gastroscopy and similar diagnostic procedures, closure of skin wounds, surgery etc.) as well as by direct contact with the blood or open sores of an infected person (2,3). Countries which introduced public vaccination programmes and disposable equipment managed to significantly reduce the risk of infection. Despite this fact, every hospitalisation and the above-listed factors constitute a risk of infection for unvaccinated persons (2). The acute hepatitis B usually develops within the first six months after infection with the virus and generally lasts for a few weeks. More than 90% of healthy adults who are infected with HBV will recover naturally within the first year. However, in patients in whom the infection persists, lasting infection of hepatocytes leads to the development of a long-term form of the disease known as chronic hepatitis B. The younger the age of acute hepatitis B infection, the greater the risk of developing chronic infection (90% in infants, 25–50% children aged 1–5, 6–10% if >5 years) (4). Chronic hepatitis is often asymptomatic, unrecognized and leads to liver cirrhosis and primary liver cancer in adulthood representing a significant global public health problem. People with chronic HBV infection have a significant 15–25% risk of death from HBV-related cirrhosis and HCC (4).
It is predicted that without successful strategy, HBV will lead to 20 million deaths between 2015 and 2030 (5). To improve public health regarding HBV, a combination of vaccination, prevention of mother-to-child transmission and treatment availability is necessary.

Hepatitis B Vaccination Hepatitis B Vaccination 06/29/2016
The Vaccine Against Hepatitis B Virus >>
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