There are many different viruses that cause hepatitis including hepatitis A, hepatitis C, Delta factor hepatitis, and hepatitis E.The initial course for hepatitis A and B may be similar but it is hepatitis B that can have long term consequences. Once infected with the hepatitis B virus, approximately 10% of the people develop a chronic permanent infection (chronic carrier state). In this group, a small proportion of people will develop slow but progressive liver damage leading to cirrhosis or hepatocellular cancer.
Hepatitis B has a long incubation period, occasionally taking up to 6 months to manifest itself. Early symptoms may be a variety of skin rashes and achy joints (arthralgia). Systemic symptoms include fever, malaise, and abdominal pain or discomfort. Ultimately the yellow color of jaundice appears, first in the whites of the eyes and then the skin. Jaundice is usually associated with dark urine and light or clay colored stools
The overall incidence of reported hepatitis B is 2 per 10,000 individuals, but the true incidence may be higher, because many cases do not cause symptoms and go undiagnosied and unreported. Pregnant women are now routinely screened for hepatitis B and, as it is a reportable disease, more accurate figures are available. One in 1,000 pregnant women are chronic carriers of hepatitis B.Hepatitis B is a public health problem because of the acute illness, the long term disability, and increased rate of liver cancer resulting from chronic infection. Mandatory reporting of this disease allows state health care workers to track people who have been exposed and to immunize contracts who have not yet developed the disease.
Screening of all donated blood has reduced the likelihood of developing hepatitis B following a blood transfusion. Donors are now required to fill out a questionnaire about their sexual and drug use activities (this is also for protection against AIDS transmission) which acts as an initial screen.