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Appendices

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Section 3. Summaries of Infectious Diseases

Hepatitis B

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
Special Considerations

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CLINICAL MANIFESTATIONS

People acutely infected with hepatitis B virus (HBV) may be asymptomatic or symptomatic. The likelihood of developing symptoms of acute hepatitis is age dependent: less than 1% of infants younger than 1 year of age, 5% to 15% of children 1 to 5 years of age, and 30% to 50% of people older than 5 years of age are symptomatic. Among people with symptomatic HBV infection, the spectrum of signs and symptoms is varied and includes subacute illness with nonspecific symptoms (eg, anorexia, nausea, or malaise), clinical hepatitis with jaundice, or fulminant hepatitis. Extrahepatic manifestations, such as arthralgia, arthritis, macular rashes, thrombocytopenia, or papular acrodermatitis (Gianotti-Crosti syndrome), can occur early in the course of the illness and may precede jaundice. Acute HBV infection cannot be distinguished from other forms of acute viral hepatitis on the basis of clinical signs and symptoms or nonspecific laboratory findings.

Chronic HBV infection is defined as presence of hepatitis B surface antigen (HBsAg) in serum for at least 6 months or by the presence of HBsAg in a person who tests negative for antibody of the immunoglobulin (Ig) M subclass to hepatitis B core antigen (IgM anti-HBc).

Age at the time of acute infection is the primary determinant of the risk of progressing to chronic infection. More than 90% of infants infected perinatally will develop chronic HBV infection. Between 25% and 50% of children infected between 1 and 5 years of age become chronically infected, whereas only 2% to 6% of acutely infected older children and adults develop chronic HBV infections. Patients who develop acute HBV infection while immunosuppressed or with an underlying chronic illness have an increased risk . . . [Go to Full Text]


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  • Perz, J. F., Elm, J. L. Jr, Fiore, A. E., Huggler, J. I., Kuhnert, W. L., Effler, P. V. (2006). Near Elimination of Hepatitis B Virus Infections Among Hawaii Elementary School Children After Universal Infant Hepatitis B Vaccination. Pediatrics 118: 1403-1408 [Abstract] [Full Version]  
  • Mercier, C. E., Barry, S. E., Paul, K., Delaney, T. V., Horbar, J. D., Wasserman, R. C., Berry, P., Shaw, J. S. (2007). Improving Newborn Preventive Services at the Birth Hospitalization: A Collaborative, Hospital-Based Quality-Improvement Project. Pediatrics 120: 481-488 [Abstract] [Full Version]  
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