Chronic infection is associated with an increased risk of developing cirrhosis, liver failure and hepatocellular carcinoma. Premature death from chronic liver disease occurs in approximately 15-25% of chronically infected people. How is Hepatitis B disease transmitted? Hepatitis B virus (HBV) has been found in virtually all body secretions and excretions. However, only blood (and serum-derived fluids), saliva, semen and vaginal fluids have been shown to be infectious. People with chronic HBV infection are the primary reservoirs of infection. Transmission mainly occurs by: • Sexual intercourse • Blood-to-blood contact • Transmission from infected mother to child • Transmission has rarely followed bites from infected individuals Transmission by transfusion of contaminated blood or blood products is now rare because of routine screening of blood donors and viral inactivation of certain blood products.