June 11, 1999

Hepatitis B infection

Hepatitis B is a serious viral infection which affects the liver. According to the Hepatitis Foundation, some 250,000 persons in the United States contract hepatitis B each year. This means that as many as one of every 20 people in this country may become infected during his/her lifetime. Though 90% or more persons infected with the virus do eventually recover from the disease, the five to ten percent (5-10%) who do not become carriers of the infection and may go on to develop long term health concerns (approximately 20,000-25,000 new chronic carriers, annually). Hepatitis B is not only one of the most common causes of acute viral hepatitis in the United States, but it is also a major cause of chronic liver diseases such as cancer, and cirrhosis.

HDHHS receives an average of 1000 reports of previously unidentified cases of hepatitis B among Houston residents, every year. There is great concern by HDHHS that the true number is being underreported in the city. Roughly ten percent (approximately 100) of the reported cases represent persons with very recently-acquired infections; the vast majority of all reported cases (80%), however, represent persons with chronic liver disease due to infection acquired at some point in the distant past.

In Houston, as in other large cities of the United States, hepatitis B infections are more prevalent among males (56%) than females (44%). Sixty-four percent of all newly infected cases in Houston during the period 1997-1998

occurred among persons aged thirty years and over; the young adult group (19-30 years) represented 31%, while older children and teens (I 1-18 years) accounted for the remaining 5% of cases. No child aged less than one year was reported during this period as having the infection. Analysis of racial and ethnic distributions of cases in Houston are unreliable as these variables are poorly documented by reporting laboratories and physicians.

Surprisingly, many persons in the community believe, erroneously, that hepatitis B can be contracted through the air, or by very casual contact such as a hug, handshake, or simply sitting next to an infected individual in an office or on a bus. Hepatitis B is most often transmitted to healthy individuals when their broken skin or mucus membranes (mouth, eyes, vaginal wall, rectum, etc) come into contact with the body fluids (particularly blood, saliva, or semen) of an infected person. Significant types of exposure are: intimate kissing or other sexual contact with an infected person(s); use/sharing of unsterilized tattoo, body-piercing, shaving, or intravenous drug paraphernalia; transmission from mother to infant during the birth process. However, in about 30-40% of cases, these risk factors are not so clearly identified, suggesting the possibility that infection can be acquired through less obvious means, such as sharing toothbrushes, or having contact with even the dried blood of an infected person.

While various therapies are being developed to treat persons with hepatitis B. the strongest weapon against the disease is still prevention through immunization and education.