Worldwide, it is the most common chronic viral infection, affecting more than 300 million people, according Adoption Medical News , a newsletter for physicians practicing international adoption medicine. The virus is a major cause of death in regions where it is endemic. Over a lifetime, about one-third of chronically infected people die from hepatitis B or one of its complications, which include progressive liver disease, cirrhosis and hepatocellular carcinoma. The highest rates of infection are in Asia and Eastern Europe, especially Romania. Tests for hepatitis B done in a child's country of origin are highly unreliable, the newsletter states.
Results are often false or confusing.
To further complicate the issue, testing done outside the United States might actually cause children to be exposed to the virus or other blood-borne infections, such as HIV, because needles are often reused.