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The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy. visits, referral to drug-treatment and harm-reduction programs, education about liver health, and prevention of transmission to others. Chapter 5 will discuss the components of viral-hepatitis services. DISEASE-SPECIFIC ISSUES RELATED TO VIRAL-HEPATITIS SURVEILLANCEMany of the difficulties that surveillance systems face in identifying and tracking cases of hepatitis B and hepatitis C are related to the complexity of the infections and their associated progression (see Figures 2-1 and 2-2). This section highlights some of those challenges. Chapter 5 will provide more detail on issues related to screening and identification. 
FIGURE 2-1 Natural progression of hepatitis B infection. Abbreviations: HBeAg, hepatitis B e antigen; anti-HBe, antibody to hepatitis B e antigen; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; HCC, hepatocellular carcinoma. aTransmission occurs in 90% of infants of HBsAg+/HBeAg+ mothers and 15% of infants of HBsAg+/anti-HBe+ mothers. b30% of those infected from the age of 1–5 years and under 7% of those infected at the age of 6 years or older. cAbout 50% of patients by 5 years and 70% of patients by 10 years will seroconvert to anti-HBe. d15-25% risk of premature death from cirrhosis and HCC.
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