Persons with chronic hepatitis B are known as "chronic carriers" ? a state of
infection which exists when hepatitis B surface antigen (HBsAg) persists in the
blood for more than six months. The likelihood of becoming a chronic carrier is
affected by the age at infection. Fewer than 6% of acutely infected adults in the
US become carriers, compared to some 25% (with HBeAg-negative moms) to
90% (with HBeAg-positive moms) of children infected in early childhood or during
birth. Perinatal infection can be prevented by prompt administration of
hepatitis B immune globulin and initiation of the three-dose hepatitis B vaccination
series.
This perinatal intervention is widely practiced in the US ? all states
have federal funding for perinatal hepatitis B prevention programs ? but not in
other parts of the world, particularly Asia and sub-Saharan Africa, where the
prevalence of chronic hepatitis B is higher to begin with. In Oregon, 50% of
chronic carriers were born in hepatitis-B-endemic countries. Chronic carriers are
at greater risk of developing life-threatening diseases (e.g., chronic active hepatitis,
cirrhosis, and/or liver cancer) decades later. Carriers will sustain transmission
of hepatitis B in the US until vaccine-induced immunity is nearly universal.
The number of chronic carriers reported each year in Oregon is four times the
number of acute cases. Keep in mind that these are newly-reported carriers, not
people who have newly become carriers. Newly-reported carriers are older than
acute cases. Chronic carriers are not reportable in many of the US states, so a
table comparing Oregon to the rest of the US is not given.
Hepatitis B (chronic)
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