AskDoctorKT

WHAT YOU MUST KNOW ABOUT HEPATITIS B VIRUS.

The first 12 weeks of my internship as a fresh doctor was highly depressing. I worked in the wards that were known for recording high mortality rates in the hospital. We lost patients almost on a daily basis. The mortalities were due to liver cancer, fulminant hepatitis and other forms of acute or chronic liver diseases. Majority of those patients were infected with the Hepatitis B virus (HBV).

In fact, I saw more patients dying of HBV and its sequelae, than I saw for HIV/AIDS. HBV is more easily transmitted (50-100 times) and can survive very harsh conditions for longer, than its counterparts like HIV. Signs and symptoms are also not specific: fever, malaise, abdominal pain, jaundice, etc. I just wonder why the awareness for this silent killer is so low…

More than 90% of infected adults are able to “clear” the virus even without active intervention, but about 10% become “chronic carriers”, transmitting the virus onto unsuspecting contacts. Less than 1% suffer severe, life-threatening infection rapidly resulting in death. By the time most chronic carriers present themselves to the hospital, the liver would have been damaged irreparably. The only cure for them is liver transplant, and we all know what that means…

OK, enough of depressing stories! Besides, a single article cannot possibly do justice to this topic. So, let me tell you the good news about this virus: IT IS PREVENTABLE. How?

*Avoid sharing sharp objects like needles, blades, syringes, clippers as well as toothbrushes.

*All surfaces contaminated with infected (or presumably infected) blood and other body fluids, must be sanitized with household bleaching agents (such as JIK, at 1:10 dilution)

*Avoid indiscriminate unprotected sexual intercourse. Know your (and your partner’s) status and be faithful to them.

*Ensure that blood and blood products are screened before transfusion.

*All hospital staff, paramedics, ambulance drivers etc, should avoid direct contact with body fluids, open wounds and cadavers. (Universal precaution)

*All children must receive HBV vaccination. It’s given at birth, 6weeks and 6months under the Nigerian immunisation schedule.

*All mothers should be screened for HBV ideally before attempting to get pregnant, and during pregnancy.

*Infected pregnant mothers should receive a specialised and more frequent antenatal care. Labour and delivery should also be well supervised.

*Infants of infected mothers should be given active and passive immunisation within 72 hours of delivery.

*All infected persons should be treated promptly and followed up by specialists.

*All sexual contacts and family members of infected individuals should also be screened and managed promptly.

There are huge amount of information on this topic which you can easily access. Visit trusted sites such as mayoclinic.org, WebMD and so on. See also WHO’s and CDC’s official websites.