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Carrier mothers transmit HBV to the newborn during the perinatal period. Ninety percent of the newborns born to HBeAg-positive mothers will beome carriers. It occurs in 50 % newborns born to HBeAg-negative carrier mothers.

Another mode of transmission, Horizontal transmission occurs on blood transfusion, operation, tatooing, ear piercing, injury of skin or mucous membrane, sexual contact especially homosexuals, intravenous drug abusers, and sharing of razors and tooth brushes.