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Intensive care, also called critical care, is the close monitoring and treatment given to patients with acute, life-threatening illness or injury such as shock, burns, accidents, sepsis, severe breathing problems and complex surgery as liver transplantation.

Hepatitis B

Chronic hepatitis B (CHB) caused by hepatitis B virus (HBV) infection remains a major global health problem affecting an estimated 350 million people worldwide with more than 786000 individuals dying annually due to complications of CHB, including cirrhosis and liver cancer. CHB is the leading cause of hepatocellular carcinoma (HCC) accounting for at least 50% of newly diagnosed cases. Furthermore, HCC is the third leading cause of cancer-related mortality in the world with a dismal 5 year survival and the fastest growing rate of cancer death in North America.

Liver transplantation (LT) is the most effective treatment in patients with CHB-related liver failure, cirrhosis and HCC. However, HBV reactivation following LT emerges as a major clinical challenge. Prophylaxis with high-dose hepatitis B immunoglobulin (HBIG) and anti-viral drugs have achieved remarkable progress in LT by suppressing viral replication and improving long-term survival.

Before its introduction, reinfection with HBV after transplantation occurred in more than 80% of recipients and the 5-year graft and patient survival rates were only 50%. Now, with the use of the HBIg/nucleoside/nucleotide analogue prophylaxis, transplant programs in North America and Europe can expect prevention of HBV recurrence in greater than 90% of their patients.  

Hepatitis B is contagious, but it can be transmitted from mothers to infants at the time of birth. This transmission can be markedly reduced by the immediate postpartum administration of HBIg to the infant either alone or, as currently recommended, concomitant administration of hepatitis B vaccine. 

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