What to know about hepatitis
Musa got to know he had hepatitis B when he applied for a job as a domestic servant to a family. The test came out positive and he was denied the job.
Rosemary felt ill for some time and went to the hospital. She was diagnosed with hepatitis during the blood screening and her offer to donate blood to an ill relative was halted.
According to Dr Bamidele Opeyemi Folorunsho, a Consultant Physician and Gastroenterologist at the Department of Medicine, Dalhatu Araf Specialist Hospital, (DASH) Lafia in Nasarawa State, hepatitis is defined simply as inflammation of the liver. Hepatitis got it name from the Latin word “hepar, hepat” which means liver and “itis” meaning inflammation, he said.
He said there are five types of hepatitis - A, B, C, D and E - adding that in subSaharan Africa, hepatitis B and C are of importance because they are blood borne and are the most common causes of liver disease. He said they could be caused by viruses, fungi, bacteria, chemical and some metabolic problems.
Dr Folorunsho said: “In this part of the world, we are most concerned about hepatitis B and C. It has been said that hepatitis B is 100 times more infectious than HIV and 10 times more infectious than hepatitis C.
“Hepatitis A is transmitted mainly through the oral route, through contaminated foods and drinks, just like Hepatitis E. However, they are less significant as people develop antibody in childhood due to poor hygiene. It could be severe among people with suppressed immunity.
“Hepatitis B is a virus that is in the group of viruses that predominantly affect the liver, and is notoriously known for causing liver disease such as longstanding inflammation in the liver called chronic hepatitis and can progress to liver-cirrhosis and ultimately liver cancer.
The consultant added that hepatitis B is not a new virus, explaining that it has been in existence since 1960 in Australia and spread with increasing prevalence worldwide. “It has become a global health challenge which has led to the creation of
an awareness day called World Hepatitis Day. This is to create awareness among the populace and to make people know their status by being screened for Hepatitis B and C,” he added.
He stated that it is possible for a patient to suffer from both Hepatitis B and C at the same time but that was associated with poor outcome with increased risk of liver disease and cancer and rapid progression of liver failure.
On the prevalence, he said viral hepatitis is pandemic with close to 400 million carriers of the B and C types all over the world.
“Out of this figure, close to 300 million people are unaware of their infection which makes it scary. People go about their daily lives without knowing. Therefore, these people are unable to make decisions about treating this infection and preventing its spread,” the physician added.
Dr Folorunsho said in Nigeria, it is endemic to the extent that close to 50 million people are infected with Hepatitis B.
“The prevalence of hepatitis B in Nigeria is 13 percent while Hepatitis C is 2.2 percent. The prevalence of hepatitis B in Nasarawa State is about 14 percent. The prevalence of viral hepatitis in Dalhatu Araf Specialist Hospital (DASH), is 12 percent from the blood bank register only. The burden of viral hepatitis in Nigeria is a reflection of the global prevalence,” he further stated.
The gastroenterologist said the symptoms of hepatitis are nonspecific, and that they mimic common illnesses such as malaria and typhoid. Some common symptoms are fever, body pain, feelings of unwell, body itching, jaundice, abdominal pain and tiredness, while symptoms such as passage of black stool, vomiting of blood, abdominal swelling may be signs of undergoing liver damage/disease which may lead to unconsciousness and later leading to death, he explained.
He said the disease is difficult to diagnose by mere looking at the person as it may resemble malaria or typhoid, adding that a high index of suspicion is required with blood tests to confirm diagnosis.
Dr Folorunsho said people who were infected with hepatitis may be involved in some practices predisposing them to the infection.
According to him, mother to child transmission is a common route, as a mother that is positive for hepatitis can transmit the virus to the new borne, especially if she has a high viral count. Babies and children are at risk of chronic infection as their immunity is under developed. There is also horizontal transmission from child to child through rubbing of saliva and scratching each other.
He said transmission could also be through break in skin from contaminated needles, clippers and blades. It can also occur in health centres via poorly screened blood, especially in rural areas. Others include skin piercing, tattooing, unprotected or unsafe sexual practices, and multiple sexual partners, among others.
The medical expert said vaccination is crucial in the prevention of the infection. “Babies delivered by hepatitis B positive mothers should be immunised. Individuals negative for hepatitis B should be vaccinated,” he said.
He said sharp objects such as razors, pins, and needles, should be properly discarded and not re-used.
“Unwanted blood and blood products should well be discarded. Blood should be screened thoroughly before transfusion. Abstinence, being faithful to one’s partner, practicing safe sex are important preventive measures. Avoid risky traditional practices such as scarifications and tribal marks.
“People who are positive for viral hepatitis should ensure that they seek medical care to prevent complications such liver cirrhosis and cancer, and also to prevent infection to others. Hepatitis A and E can be prevented through good hygiene,” he advised.
He said the first step to treatment is to be tested! Adding that, Hepatitis B virus has no cure but can be managed with effective treatment while Hepatitis C could be treated effectively and cured.