How does the mode of transmission of hepatitis B (HBV) (Hep B) vary among global regions?

Updated: Jun 08, 2021
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Sexual and percutaneous transmission and transmission during delivery are the major transmission routes in areas of intermediate prevalence (rate of 3-5%). These regions include Eastern and Northern Europe, Japan, the Mediterranean basin, the Middle East, Latin and South America, and Central Asia. One study reported approximately 43% of HBV-infected individuals live in South Central and West Asia, Eastern Europe, Russia, and Central and South America, with a prevalence rate of 2-7% and a lifetime HBV risk of 20-60%. [8]

In areas of high prevalence (≥8%, generally 10-20%), the predominant mode of transmission is perinatal, and the disease is transmitted vertically during early childhood from the mother to the infant. Approximately 45% of individuals infected with HBV live in high-prevalence areas, with a lifetime infection risk of over 60%, as demonstrated by the presence of hepatitis B core antibodies (anti-HBc) to hepatitis B core antigen (HBcAg) in serum. [8] Such regions include China, Southeast Asia, Indonesia, sub-Saharan Africa, Pacific Islands, parts of the Middle East, and the Amazon Basin.

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