Hepatitis B Awareness

Hepatitis B is a serious liver disease caused by hepatitis B virus (HBV).
One-third of the world population has been infected with HBV. 350 million people worldwide have chronic HBV infection. In Nigeria ,the prevalence is about 15-40% depending on the state involved.
The chronic form of the disease is said to be a silent killer (disease) because most people with chronic hepatitis B do not know that they have been infected.
1 in 4 people with chronic hepatitis B will die from liver cancer or liver failure.
Thus, effective education, screening, and vaccination are necessary to stop this silent hepatitis B epidemic.
It is said to be 100 times more infectious than HIV.

WORLD HEPATITIS DAY
This is marked on July 28th yearly
This focuses the individual, community groups, clinicians and other supporters to run awareness raising events.

NOTE
HBV is one of the varied causes of hepatitis which include other hepatotrophic viruses (A, C, D, E), EBV, CMV, Drugs (isoniazide, aldomet etc), alcohol amongst others,

SYMPTOMS
HBV damages the liver causing scarring and fibrosis and can lead to liver cancer.
Disease caused by HBV
 Acute hepatitis
 Fulminant hepatitis
 Chronic hepatitis
 Liver cirrhosis
 Liver cancer

ACUTE HEPATITIS B (infection within 6 months)
May have no symptoms, or may have mild flu-like symptoms, including fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, muscle and joint pain, and jaundice (yellow color skin or eyes).Most people recover uneventfully.

CHRONIC HEPATITIS B (infection longer than 6 months)
Usually do not have any symptoms (hence a silent disease) for as long as 20 to 30 years. Chronic hepatitis B may cause liver damage, liver failure, liver cirrhosis (liver scarring), liver cancer, and death.
Most people with chronic hepatitis B were infected at birth or during early childhood.


CIRRHOSIS/LIVER CANCER
This presents with abdominal swelling, abdominal pain, Leg swelling, weight loss, jaundice, bleeding, confusion, coma etc
They are usually very ill.

TRANSMISSION
Hepatitis B can be spread via blood, Fluid, vaginal fluid, or other body fluid, such as by
 Birth- Mother to child
 Unprotected sex heterosexual/homosexual(MSM)
 Sharing/use of contaminated needles(piercing,tatooing,acupuncture), syringes, razors, toothbrushes
 Needle stick injuries in healthcare settings
 Unsafe blood transfusion /organ transplant
 Direct contact with the blood or open sores of an infected person
NOTE
Hepatitis B CANNOT be spread by sharing utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing.

WHO IS AT RISK
 Infants born to infected mothers
 People who have unprotected sex with infected people
 Men who have sex with men (MSM)
 Injection-drug users who share contaminated needle, syringes, or other drug equipments with infected people
 Healthcare workers who are exposed to blood on the job
 Hemodialysis patients
 People born in or who travel to countries with high rates of hepatitis B.Countries in Asia, Pacific Islands, and in southern Africa all have greater than 8% of population infected with chronic hepatitis B.
 People with HIV

LAB TEST
 Blood test to detect the virus
 Liver biopsy
 Abdominal USS amongst others.

TREATMENT

Acute hepatitis B,
There is no specific treatment available, but people should be resting, have adequate nutrition and fluids, and may need to be hospitalized. (Symptomatic treatment).


Chronic hepatitis B
There are approved medications, but not everyone with chronic hepatitis B needs treatment. See your doctor.
Transplant is also a treatment modality.
You should also take care of your liver by avoid drinking alcohol and taking other medications that can further damage the liver including herbal medications.

Abdominal ultrasound scans 6 monthly – to monitor the development of liver cancer

PREVENTION
 Vaccination(Hepatitis B vaccine)
This is the most important method. It is indicated in all infants, children, and adults in high risk group.
3-4 shots administered over a 6month period
Newborn - birth, 1-2 month and 6 month
Adult - 0, 1-2 month and 6 month
 Safe sex-condom/abstinence/be faithful
 Avoid sharing sharps needles, toothbrushes etc
 Avoid alcohol, medications(including herbal) that could further damage the liver
 Prevent perinatal transmission by vaccinating babies at birth
 Bandage /cover all cuts /open wound
 Screening of blood and blood products.
 Use of PPE by healthcare workers-facemask,handgloves etc
 Eat vegetables/fruits in addition to normal CHO/Protein diet

HEPATITIS AND PREGNANCY
70-90% of infants born to HBV positive mothers will be infected.90% of infected infant become chronically infected.
Baby shots for hepatitis B if mother has hepatitis B.
At birth - Hepatitis B vaccine + HBIG
1-2 months - Hepatitis B vaccine
6 months - Hepatitis B vaccine

What do the baby shots do?
These shots help babies’ bodies make antibodies, which protect them from hepatitis B.When an adult or baby has antibodies for hepatitis B, this helps fight off the virus.
A few months after your baby gets H-BIG(hepatitis B immune globulin) and all 3 shots of HBV vaccine, the doctor will do a simple blood test. The test tells you if your baby is making antibodies.

What if my baby does not get these shots?
 Up to 9 out of 10 babies born to infected mothers will end up being carriers for the rest of their lives, if they do not get the shots.
 Babies who end up as carriers have a 1 out of 4 chance of dying from liver problems
 19 out of 20 babies who get the shots will be protected for life!
Can I breast-feed my baby if I have hepatitis B?
YES! If your baby gets a shot called H-BIG(Hepatitis immune globulin) and a shot of hepatitis B vaccine within 12 hours of birth, it is okay for you to start breast-feeding your baby right away. Be sure to take good care of your Tip areas to prevent cracking and bleeding.
REASSURANCE
It is not a death sentence,people may live a normal life and die of old age or unrelated cause.