Hepatitis B is a serious liver disease caused by the hepatitis B virus (HBV). The Centers for Disease Control and Prevention (CDC) estimate that 78,000 new HBV infections occur each year. HBV is spread through contact with the blood or other body fluids of an infected person. HBV can be spread to others one to two months before and after the onset of symptoms.
About 5% of all acute HBV infections progress to chronic infection. The risk of chronic infection is greatest in infants and younger children. For example, 30% to 50% of children infected with HBV between 1 year and 5 years of age become chronically infected. In contrast, only 5% of adults become chronically infected. People who are chronically infected do not have symptoms, but they are able to spread HBV to others and are called carriers. In addition, about 25% of persons with chronic HBV infection die prematurely from cirrhosis or liver cancer.
There are two hepatitis B vaccines: Recombivax HB and Engerix-B. Both are inactivated recombinant vaccines. They are available in both adult and pediatric formulations. In addition, Recombivax HB is available in a formulation for persons on dialysis. Hepatitis B vaccine is also commonly administered as a combination vaccine with DTaP, IPV, hepatitis A, and/or Hib vaccine.
Product: Engerix-B® (Hepatitis B)
Year licensed: 1989
Product Name: Recombivax HB® (Hepatitis B)
Manufacturer: Merck & Co
Year licensed: 1986
Product Name: Comvax® (Hib and hepatitis B)
Manufacturer: Merck & Co
Year licensed: 1996
Product Name: Pediarix® (IPV, DTaP, and hepatitis B)
Year licensed: 2002
Product Name: Twinrix® (Hepatitis A and hepatitis B)
Year licensed: 2001
All unvaccinated adults at risk for HBV infection should be vaccinated. This includes:
* Hepatitis B vaccine may be administered at the discretion of the healthcare provider to unvaccinated adults with diabetes mellitus who are 60 years of age and older.
* Some products may contain yeast, neomycin, and aluminum hydroxide. The tip cap and the rubber plunger of the needless prefilled syringes may contain dry natural latex rubber.
*When hepatitis B antigens are given in combination with other antigens in one vaccine, the other antigens in the vaccine may cause other side effects. For more information about these possible side effects, go to the Hepatitis A, Pertussis, Diphtheria, Tetanus, Hib, and Polio pages.
People who do not recover from hepatitis B infection are chronically infected, and there are over 1 million chronically infected people in the United States today. A chronically infected person is someone who has had hepatitis B virus in her or his blood for more than 6 months.
About 5% of adults who acquire hepatitis B infection become chronically infected, but children younger than 5 years of age have a greater risk. The younger the child is at the time of infection, the greater the risk that the child will have a lifelong infection. Many babies born to chronically infected mothers will also become chronically infected with hepatitis B virus, unless the babies are given two shots in the hospital and at least two more during the 6 months after birth to protect them from the infection.
A chronically infected person usually has no signs or symptoms of hepatitis B infection, but remains infected for years or for a lifetime and can pass hepatitis B virus to others. Sometimes, chronically infected people will clear the infection from their bodies on their own, but most will not. Although most chronically infected people have no serious problems with hepatitis B and lead normal, healthy lives, some develop liver problems later. Chronically infected people are at much higher risk than the general population for liver failure or liver cancer.