Hepatitis B 4
Hepatitis B 4 : Viral disease caused by the hepatitis B virus that is endemic worldwide, the areas of highest endemicity being China and Southeast Asia, subSaharan Africa, most Pacific islands, and the Amazon basin. The virus is shed in all body fluids by individuals with acute or chronic infections and by asymptomatic carriers, and is transmitted primarily by parenteral routes, such as by blood transfusion or by sharing of needles among drug users; oral transmission can occur but has low efficiency, and it can be spread by intimate personal contact, especially sexual contact, and by vertical transmission from mother to neonate. Incubation period averages about 90 days, with a range of 40 to 180 days, the clinical course is more variable than in hepatitis A. During the prodromal phase there may be fever, nausea, malaise, anorexia, and vomiting, which lessens with the onset of clinical jaundice, and urticaria, angioedema, arthritis, or, rarely, glomerulonephritis or a serum sickness like syndrome may occur. Most patients recover completely and become HBS Ag-negative in 3 to 4 months, some will remain chronic carriers or develop chronic active hepatitis or chronic persistent hepatitis. Massive hepatic necrosis (fulminant hepatitis) is an infrequent complication. In areas of high endemicity a relationship has been shown between hepatitis and virus infection, cirrhosis, and primary hepatocellular carcinoma, with the latter being one of the most common neoplasms. Previously called inoculation hepatitis, long incubation hepatitis, MS2 hepatitis, serum hepatitis, and homologous serum hepatitis or jaundice.
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