Hepatitis B virus is estimated to chronically infect over one million Americans and up to 350 million people worldwide. It is the leading cause of chronic liver inflammation, cirrhosis and liver cancer in the world.

Hepatitis B virus becomes chronic in about 5% of those infected. A person is considered to have chronic infection if the HbsAg test is positive for over six months. This is considered to be a carrier state, and is characterized by low levels of circulating virus and a generally good prognosis.

Carriers of the virus are considered to be infected even though their liver disease is not active. They generally do not require therapy. They should be checked every six months with liver function testing. Most cases that show no progression are standard issues, although the disease can reactivate at any time.

Those who have active inflammation (as seen by increased liver enzymes and liver biopsy results) are at risk for liver cancer, cirrhosis and liver failure. Liver biopsies are important to evaluate these people to show the degree of active inflammation and liver fibrosis, or permanent damage. Those people who have chronic disease shown to be active often require antiviral therapy.

Rating of hepatitis B infection is dependent on several factors. Those who have had the disease since birth generally have more problems than those who acquire it as adults. People from countries where the infection rate at birth is much higher will be rated more aggressively. Results of liver biopsy results are of key importance- those with active disease or high levels of fibrosis may be highly rated or declined. Those who have the presence of antibodies to hepatitis B do the best over the long term. Of course those in whom mitigating factors are known (e.g. IV drug use) have their own set of risks that have to be evaluated on an individual basis. Liver function tests are usually available to the underwriter as well which factor into a final decision.

The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.