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Point to Point continued
Recall for some people, HBV is an acute, or short term illness but for others such as infants and adolescents, it can become a long term, chronic infection. The chronic version of HBV can cause a chronic liver infection that can later develop into cirrhosis of the liver and liver cancer. The likelihood that an infection with the virus becomes chronic depends on the age at which a person becomes infected. Children less than 6 years old who become infected with the hepatitis virus are the most likely to develop chronic infections. According the World Health Organization, (WHO) 80-90% if infants infected during the first year of life develop chronic infections and 30-50% of children infected before the age of 6 years old develop chronic infections.
The primary reason hepatitis vaccinations are strongly recommended is because of the dangerously long incubation period of the disease. The incubation period of the hepatitis virus can be as long as 120 days after initial exposure. During that time, most victims will typically not show symptoms but still be shedding millions of HBV particles in their stool, saliva, vaginal discharges and urine.
Laboratory diagnosis of HBV as well as HAV focuses on the detection of the hepatitis surface antigen HBsAG. If the antigen is present, there is a high likelihood that the virus is in the human bloodstream. Early detection of prostate cancer is done the same way. Blood is drawn and analyzed for prostate specific antigen (PSA). High numbers trigger additional testing in the same way the antigen for HBV is detected in the bloodstream. The World Health Organization recommends that all blood donations be tested for HBV to ensure blood safety and avoid accidental transmissions to people who receive blood products.
In 2015, WHO launched its first “Guidelines for the Prevention, Care and Treatment of Persons Living with Chronic Hepatitis Infection.” Their recommendations are to promote the use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility of treatment, to prioritize treatment for those with the most advanced liver disease and recommend the preferred use of nucleotide analogues with a high barrier to drug resistance in children between the ages of 2-11 years for first and second line treatment.
When babies become infected at birth or during infancy, only 10% clear the infection due to their immature immune systems. The remaining 90% develop chronic HBV. Most pregnant women do not know whether they are infected with HBV due to the lack of symptoms and extended incubation period and can unknowingly pass the virus to their newborns during child birth. Therefore, since the risk of newborns becoming chronically infected at birth is so high, both the WHO and CDC recommend that all infants receive their first dose of the HBV vaccine within 12-24 hours after birth. O
Point to Point with Jay Cousins
Jay Cousins works for the Albuquerque Environmental Health Department. He started working for the city in 1985. In 1994 he started working for the restaurant, swimming pool, and body art inspection program. He has approxi- mately 600 facilities in his jurisdiction, including body art establishments. He started doing body art inspections in 1999 and has conducted over 500 body art facility inspections since then.
Jay is also a high school and college baseball umpire and works as a fill-in umpire for the Albuquerque Isotopes.
Jay Cousins
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