Persons at risk

• Health-care and public-safety workers at risk for occupational exposure to blood or blood-contaminated body fluids

• Residents and staff of facilities for developmentally disabled persons

• Persons who have chronic liver disease

• Hemodialysis patients

• Travelers to countries that have intermediate or high prevalence of HBV infection

• Patients who have signs or symptoms of liver disease (for example, abnormal liver-enzyme tests)

• Children born to HCV-positive mothers (to avoid detecting maternal antibody, these children should not be tested before the age of 18 months)

Potential for chronic infection

Among newly infected, unimmunized persons, chronic infection occurs in:

• >90% of infants

• 25–50% of children aged 1–5 years

• 6–10% of older children and adults

75–85% of newly infected persons develop chronic infection

Clinical outcomes

• 15–25% of chronically infected persons will die from cirrhosis, liver failure, or hepatocellular carcinoma

• 3,000 deaths each year are due to hepatitis B-related liver disease in the United States

• 60–70% of chronically infected persons develop chronic liver disease

• 5–20% develop cirrhosis over a period of 20–30 years

• 1–5% will die from cirrhosis or hepatocellular carcinoma

• 12,000 deaths each year are due to hepatitis C-related liver disease in the United States