The term “healthy carrier” is misleading and should be discontinued. A "carrier" is someone who is chronically infected with hepatitis B. Many chronically infected patients do not show symptoms and have normal liver function tests, but are still at increased risk for liver cancer and liver damage. Therefore, it is critical to remain vigilant about regular screening for liver damage (with ALT tests every 6 months) and liver cancer (with AFP tests every 6 months and an ultrasound every year).
No. Hepatitis B is transmitted like HIV: from an infected mother to her child at birth, through contaminated blood, or through unprotected sex. A different virus, the hepatitis A virus, is spread through food and water contaminated by human fecal waste.
People with chronic hepatitis B can lead completely normal and active lives. With regular ALT and AFP tests every 6 months and an ultrasound every year, liver disease can be detected early and treated quickly to prevent further damage, which will increase the probability of long-term survival.
Hepatitis B is NOT a hereditary disease. However, mothers with high HBV DNA levels or who test positive for HBsAg are at the greatest risk of infecting their newborns. HBsAg positive mothers can protect their newborns from becoming chronically infected with hepatitis B if the newborn receives the first dose of the hepatitis B vaccine and the hepatitis B immune globulin (HBIG) shot within 12 hours of birth, and completes the 3-dose hepatitis B vaccination series. This will prevent more than 95% of babies born to chronically infected mothers from acquiring hepatitis B.
The CDC does not recommend a routine booster shot of the hepatitis B vaccine. Successful completion of the 3-shot vaccination series provides long-term protection against the hepatitis B virus in most of those vaccinated.
There is no clear explanation for the endemic persistence of hepatitis B in Asia, though lack of symptoms, testing, vaccination, and awareness are all contributing factors. Because mother-to-child transmission is common in Asians, hepatitis B infection is often passed silently from generation to generation. However, anyone (regardless of race or gender) without proper vaccination is susceptible to hepatitis B infection.