In endemic areas of high transmission generally occur from mother to baby, if the mother is infected with HBV (HBsAg positive mothers) means an infection in the womb or infection early in life will bring high levels of chronicity by 80-90%, in children ages 1 -4 years will experience the chronicity of 30-60%. (13) In the low endemic countries, transmission is usually in adulthood with generally self-limiting infection. The most common mode of transmission in the area of low endemicity is horizontal transmission occurring in adults, usually through sexual and use of contaminated needles in medical procedures or intravenous drug use (14). HBV infection deaths occur because of chronic liver cancer or liver cirrhosis were found to have been infected while in the womb or early in life. If not infected in the perinatal period, then the babies of HBsAg positive mothers remain at high risk of developing chronic hepatitis B virus infection through horizontal transmission in the first 5 years of life
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