Very few people know about Hepatitis, that it is more deadly than HIV/AIDS and kills scores of people per week.
There are three categories of Hepatitis-A, B and C. According to the World Health Organisation, WHO, Hepatitis B virus can survive outside the body for at least seven days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine. The incubation period is 75 days on average, but can vary from 30 to 180 days.
“The virus may be detected within 30 to 60 days after infection and can persist and develop into chronic hepatitis B. In highly endemic areas, it is commonly spread from mother to child at birth (prenatal transmission), or through horizontal transmission (exposure to infected blood), especially from an infected child to an uninfected one during the first five years of life.
The development of chronic infection is very common in infants infected from their mothers or before the age of five. It is also spread by percutaneous or mucosal exposure to infected blood and various body fluids, as well as through saliva, menstrual, vaginal and seminal fluids. Sexual transmission of hepatitis B may occur, particularly in unvaccinated men who have sex with men and heterosexual persons with multiple sex partners or contact with sex workers.
“Infection in adulthood leads to chronic hepatitis in less than five percent of cases. Transmission of the virus may also occur through the reuse of needles and syringes either in health-care settings or among persons who inject drugs. In addition, infection can occur during medical, surgical and dental procedures, tattooing or through the use of razors and similar objects that are contaminated with infected blood.”
However, most people do not experience any symptoms during the acute infection phase. Some have acute illness with symptoms that last several weeks including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. A small subset of persons with acute hepatitis can develop acute liver failure which can lead to instant death. In some people, the virus can also cause chronic liver infection that can later develop into cirrhosis of the liver or liver cancer.
More than 90 percent of healthy adults who are infected with the hepatitis B virus will recover naturally within the first year.
Furthermore, the likelihood that infection with the virus becomes chronic depends on the age at which a person becomes infected. Children less than six years of age who become infected are most likely to develop chronic infections.
Records from WHO revealed that “80–90 percent of infants infected during the first year of life develop chronic infections; 30–50 percent of children infected before the age of six develop chronic infections. Five percent of otherwise healthy persons who are infected as adults will develop chronic infection; 20–30 percent of adults who are chronically infected will develop cirrhosis and/or liver cancer.”
On diagnosis, it is not possible, on clinical grounds, to differentiate hepatitis B from hepatitis caused by other viral agents, hence laboratory confirmation of the diagnosis is essential. A number of blood tests are available to diagnose and monitor people with hepatitis B. They can be used to distinguish acute and chronic infections.
“Laboratory diagnosis of hepatitis B infection focuses on the detection of the hepatitis B surface antigen HBsAg. WHO recommends that all blood donations are tested for hepatitis B to ensure blood safety and avoid accidental transmission of the virus.”
While there is no specific treatment for acute hepatitis B, care is aimed at maintaining comfort and adequate nutritional balance including replacement of fluids lost from vomiting and diarrhoea.
Chronic hepatitis B infection can be treated with drugs including oral antiviral agents. Treatment can slow the progression of cirrhosis, reduce incidence of liver cancer and improve long term survival.
WHO recommends the use of oral treatments such as tenofovir or entecavir because they are the most potent drugs to suppress hepatitis B virus. They rarely lead to drug resistance as compared with other drugs, are simple to take (1 pill a day) and have few side effects.
However, in most people, the treatment does not cure hepatitis B infection, but only suppresses the replication of the virus. Therefore, most people who start hepatitis B treatment must continue it for life. Treatment using interferon injections may be considered in some people in certain high-income settings, but its use is less feasible in low-resource settings due to high cost and significant adverse effects requiring careful monitoring.
There is still limited access to diagnosis and treatment of hepatitis B in many resource-constrained settings and many people are diagnosed only when they already have advanced liver disease. Liver cancer progresses rapidly and since treatment options are limited, the outcome is in general poor areas.
In low-income settings, most people with liver cancer die within months of diagnosis. In high-income countries, surgery and chemotherapy can prolong life for up to a few years and liver transplant is sometimes used in people with cirrhosis, with varying success.
Although, prevention remains the best-bet against the infection, “The hepatitis B vaccine is the mainstay of its prevention. WHO recommends that all infants receive the vaccine as soon as possible after birth, preferably within 24 hours. The birth dose should be followed by two or three doses to complete the primary series. In most cases, one of the following two options is considered appropriate:
“A three-dose schedule of hepatitis B vaccine, with the first dose (monovalent) being given at birth and the second and third (monovalent or combined vaccine) given at the same time as the first and third doses of diphtheria, pertussis (whooping cough), and tetanus – (DTP) vaccine; or four doses, where a monovalent birth dose is followed by three monovalent or combined vaccine doses, usually given with other routine infant vaccines.
“The complete vaccine series induces protective antibody levels in more than 95 percent of infants, children and young adults. Protection lasts at least 20 years and is probably lifelong. Thus, WHO does not recommend booster vaccination for persons who have completed the three dose vaccination schedule.’’
Against the backdrop of the prevalence of hepatitis in the country, a medical doctor in the Department of Family Medicine, University of Ilorin Teaching Hospital, UITH, Dr. Bode Ogunjemilua, has appealed to the federal government to provide hepatitis vaccine to the people free of charge.
He noted that among the major problems currently confronting the people is poverty which has made it difficult for them to know their health status in the face of hunger, joblessness, as well as ignorance just to mention a few.
According to him, “Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic diseases. The virus is transmitted through contact with the blood or other body fluids of an infected person. An estimated 240 million people are chronically infected with hepatitis B (defined as hepatitis B surface antigen positive for at least six months). More than 780,000 people die every year due to complications including cirrhosis and liver cancer. Hepatitis B is an important occupational hazard for health workers. However, it can be prevented by safe and effective vaccine.
“Although, it is a deadly disease, but carriers can still live with it for a very long period of time subject to the observation of the rules and instructions given by doctors. Not knowing your health status is like sitting on a keg of gunpowder which can explode at any time.
“However, carriers can live with it beyond their expectations, the secret is that they should avoid taking herbs, alcohol, hard drugs and indiscriminate taking of Paracetamol because all these products go through the liver and weakens it. Rather, try to contact your doctor in case of any health related issues. Self medication is also very bad and not advisable at this point.”
Ogunjemilua noted that ‘‘complete hepatitis vaccines are taken at 0 hour-four weeks-six months. Once you are have been vaccinated against it, you can’t contact it again.”
The medical expert, however, maintained that awareness, advocacy and campaign are highly desired to save more lives from this deadly disease, stressing that it is also common during birth and can be passed on to a newly born baby.
Similarly, a philanthropist, Hajiya Mariam Bola Yusuf, urged parents to be vigilant and conscious of the deadly disease, noting that so many families/households have been distabilised and ruined due to the infection.
She, however, called on government at all levels to take health related matters seriously and admonished the leadership of the National Assembly to fast track motions that will urgently address the porous health situation in the country.
“Health is Wealth and there cannot be any substitute to it. Screening of blood before transfusion should be given adequate attention, so as to curb the menace. Also, the vaccine has an excellent record of safety and effectiveness and should be taken seriously.”

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