In areas where HBV infection is endemic, transmission from mother to child during the birthing process is a major source of virus acquisition. Infants living in such areas also face a high risk of infection during the first year of life, through contact with HBV positive household members.
Interestingly, one of the major factors that influences the transition of HBV from an acute to a chronic infection is based on age at acquisition of the virus. In areas where the HBV virus is acquired perinatally, the immune system is not able to distinguish a difference between the virus and the host. Because of this, there is no immunologic response to hepatocyte-membrane HBV proteins – which are associated with acute hepatitis infections. Instead, chronic, lifelong HBV infections are established in 90% of perinatally infected individuals.
In these perinatally infected individuals, low-level liver injury occurs, and accounts for approximately 40% of lifetime death in HBV positive men. For unknown reasons, the lifetime risk of death due to HBV-related liver injury is slightly lower in women.
Dienstag, Jules L.
2008 Hepatitis B Virus Infection. New England Journal of Medicine 359(14):1486-1503.
Well, that is interesting, because we immunize kids on day 1 of life to prevent HBV. So I guess it may mean the the vacciation route can provide immunity, while the "natural" acquisition from mother does not. Is anything know about that?
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