| Comments |
Only about 10% of children and 30-50% of adults develop jaundice after infection. Severity ranges from no symptoms to a fatal infection in about 1% of cases. The hepatitis B antigen (HBsAg) first becomes detectable as early as several weeks before onset of symptoms; it persists in the serum of patients with chronic infection. Chronic hepatitis B infection exists in about 0.5% of North American adults and about 0.1-20% of adult populations in other parts of the world. Patients with chronic infection have increased risk for cirrhosis and liver cancer. Non-immunized workers exposed to blood from an HBsAg-positive source should receive HBIG, and the vaccine series should be started. Presenting symptoms in some cases include abdominal discomfort, arthralgias, and rash. Fever may be absent. Mucosal transmission occurs. [CCDM, p. 253-61] Other common symptoms are loss of appetite, dark urine, and light-colored stools. Symptoms occurring in less than 30% of patients include headache, myalgia, arthralgia, diarrhea, and constipation. Less than 1% of adult patients develop fulminant hepatitis with bleeding diathesis (GI bleeding) and coma. [ID, p. 761, 770] In areas of the world where carrier rates are high, most infections occur in neonates and children, and the rate of progression to chronic infection is high (20-50% progression to chronic infection) compared to parts of the world where carrier rates are low and most infections occur in adults (5% progression to chronic infection). [PPID, p. 1431] "Healthcare personnel who have received hepatitis B vaccine and developed immunity to the virus are at virtually no risk for infection. For a susceptible person, the risk from a single needlestick or cut exposure to HBV-infected blood ranges from 6-30% and depends on the hepatitis B e antigen (HBeAg) status of the source individual." [Exposure to Blood. http://www.cdc.gov/ncidod/hip/Blood/exp_blood.htm] |
|---|
