Journal of Vaccine Research 2024, Vol.14, No.3, 107-119 http://medscipublisher.com/index.php/jvr 109 and implement targeted public health interventions are essential to reduce the burden of HBV and achieve the WHO's goal of eliminating viral hepatitis as a public health threat by 2030 (Locarnini et al., 2015; Razavi ‐ Shearer et al., 2018). 3 Health Impact of Hepatitis B 3.1 Acute vs. chronic infection Hepatitis B virus (HBV) infection can manifest in two primary forms: acute and chronic. Acute HBV infection is typically a short-term illness that occurs within the first six months after exposure to the virus. Symptoms can range from mild to severe and may include jaundice, fatigue, abdominal pain, and nausea. In most healthy adults, the immune system can clear the virus, leading to complete recovery without long-term health issues. However, in some cases, acute infection can lead to fulminant hepatitis, a rare but severe form of liver failure that can be fatal (Chen and Gluud, 2005; Zanetti et al., 2008). Chronic HBV infection, on the other hand, occurs when the virus remains in the body for more than six months. This is more likely to happen if the infection is acquired at birth or during early childhood, as the immune system is less likely to clear the virus at these stages. Chronic HBV can lead to serious health problems, including cirrhosis (scarring of the liver), liver failure, and hepatocellular carcinoma (HCC), a type of liver cancer. Chronic infection is a significant global health issue, with an estimated 360 million people living with chronic HBV worldwide (Figure 1) (Shepard et al., 2006; Ott et al., 2012; Gomes et al., 2019). Figure 1 Prevalence of Hepatitis B Infection in Children Under 5 and Adults Aged 10-19 by Region, 2005 (Adapted from Ott et al., 2012) Image caption: This map illustrates the prevalence of hepatitis B virus (HBsAg) infection in different regions among children under 5 years old and adults aged 10-19 years in 2005; The colors represent different prevalence levels: light yellow (<2%, low), yellow (2%-4.9%, low-intermediate), orange (5%-7.9%, intermediate-high), and red (≥8%, high); The map shows that Africa and parts of Asia have high prevalence rates of hepatitis B, especially Central and Western Africa, where both children and adult infection rates exceed 8%; In contrast, North America, South America, Europe, and Oceania have lower infection rates, with most areas having a prevalence of less than 2%; These regional differences in prevalence may be related to factors such as vaccine coverage, healthcare conditions, and public health policies; This information is crucial for developing and implementing vaccination strategies and public health policies (Adapted from Ott et al., 2012) 3.2 Morbidity and mortality The morbidity and mortality associated with HBV are substantial. Chronic HBV infection is a leading cause of liver-related morbidity and mortality globally. Each year, approximately 600 000 people die from HBV-related liver diseases, including cirrhosis and HCC (Goldstein et al., 2006; Shepard et al., 2006). The progression from chronic HBV infection to cirrhosis and HCC is a major concern, as these conditions significantly reduce life expectancy and quality of life.
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