Prevention and treatment of Hepatitis B

Hepatitis B is one of the two most common viral diseases. The World Health Organization estimates that up to 354 million people worldwide live with Hepatitis B or hepatitis C. In Africa, up to 81 million people are chronically infected with Hepatitis B. “Hepatitis types B and C lead to chronic disease in hundreds of millions of people and together are the most common cause of liver cirrhosis, liver cancer, and viral hepatitis-related deaths,” the WHO says.

So what is this disease?

According to the Centre for Disease Control, Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). Hepatitis B is spread when blood, semen, or other body fluids from a person infected with the virus enters the body of someone who is not infected. “This transmission happens through sexual intercourse, exposure to body fluids such as saliva, menstrual blood, seminal and vaginal fluids, during childbirth, and through sharing drug-injection equipment such as needles and syringes, and piercings” states the CDC.

In addition, WHO explains that in affected areas, the most common form of transmission is perinatal. This is the spread from mother to child during birth. “Horizontal transmission is also a common mode of transmission. It refers to exposure to infected blood. This type of disease transmission is very common between infected and uninfected children during the first five years of life,” the WHO says.

Hepatitis B virus can survive outside the body for at least 7 days. “During this time, the virus can cause infection if it enters the body of a person who is not protected by the vaccine,” says the global health authority.

The symptoms

When one is infected with Hepatitis B, one will not always exhibit symptoms related to the disease. Symptoms will range from mild to acute. According to the CDC, the symptoms will include fatigue, poor appetite, stomach pain, nausea and vomiting, and jaundice (yellowing of the skin and the eyes). Other symptoms may include dark urine and liver failure.

“For many people, hepatitis B is a short-term illness. For others, it can become a long-term, chronic infection that can lead to serious, even life-threatening health issues like cirrhosis or liver cancer which cause high morbidity and mortality,” the CDC states.

Risk for chronic infection

The risk and level of infection vary from one age group to another. The majority of infants who contract Hepatitis B go on to develop chronic infection. However, few people who contract Hepatitis B in their adulthood develop chronic illness. “Hepatitis B infection acquired in adulthood leads to chronic hepatitis in less than 5 percent of cases, whereas infection in infancy and early childhood leads to chronic hepatitis in about 95 percent of cases,” the WHO states. The CDC adds that persons with chronic liver disease including, but not limited to, persons with cirrhosis, fatty liver disease, and alcoholic liver disease are also prone to a higher risk of chronic infection.

Prevention

According to WHO, vaccination is the most effective method of prevention against Hepatitis B. The available vaccines are potent enough to offer between 98 percent and 100 percent protection against this disease. “Vaccination against Hepatitis B is integral in averting the development of complications such as liver cancer and chronic ailments,” the WHO states.

Because infection and risk of chronic ailment are prevalent among children, the WHO recommends widespread vaccination against Hepatitis B during infancy and childhood. In Kenya, newborns receive the Hepatitis B vaccine at weeks 6, 10, and 14. These doses are administered at 0.5mls through injection at the left outer thigh. According to the Kenya Expanded Programme Immunization Schedule, these doses are contained in a single shot known as Pentavalent Vaccine. The Pentavalent Vaccine contains five antigens (diphtheria, pertussis, tetanus, and Hepatitis B and Haemophilus Influenzae Type b). 

Treatment

According to WHO, there is currently no known treatment for chronic Hepatitis. The method employed during hospital care is medical management and alleviation of the symptoms. “Care is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids lost from vomiting and diarrhoea,” the WHO states. Additionally, WHO recommends the use of oral treatments with tenofovir or entecavir as the most potent way of suppressing the Hepatitis B virus.