Hepatitis B, a viral infection affecting the liver, has been cited as the leading cause of liver cancer in Africa, with some estimates attributing up to 80 per cent of liver cancers to hepatitis B infection. This presents an opportunity for intervention as hepatitis B is preventable through vaccination.
Hepatitis B virus is highly infectious and can be spread in a variety of ways. Examples include from mother to child around the time of delivery, transfusion of infected blood and blood products, dialysis, sexual intercourse, particularly with multiple partners, use of injectable drugs, and prolonged close contact with those who are infected.
There are two phases of hepatitis B, acute and chronic. If one is exposed to Hepatitis B virus, then the initial infection is termed acute. Overall, only about a third of infected adults will have symptoms such as yellowness of the eyes and abdominal pain.
Most others will either have no symptoms, or only mild symptoms which can easily be mistaken for flu or malaria. It is rare for children to display symptoms.
After an acute hepatitis B infection, there may be complete recovery, or progression into chronic disease. Chronic hepatitis B is diagnosed by the persistence of certain blood markers of hepatitis about six months, or more after the initial infection.
Most adults will not progress to chronic disease, but a large proportion of children who are infected from birth, or below the age of five years will develop the chronic form. The key concern in chronic Hepatitis B is the risk of development of liver cirrhosis and, or liver cancer.
When symptoms develop in acute hepatitis B, management is supportive with rest, adequate hydration and proper nutrition. There is no specific treatment or cure for acute hepatitis B.
Hepatitis B is preventable by vaccination and is included as part of the Kenya Expanded Programme on Immunisation. Newborn babies are vaccinated at the age of six weeks, 10 weeks and 14 weeks. – By Dr Allan Rajula, Consultant Gastroenterologist and Dr Felix Riunga, Consultant in Infectious Diseases at Aga Khan University Hospital, Nairobi.