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Sunday, December 6, 2020

Hepatitis B: the unnoticed virus living amongst our population

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 By Fanta Fofana

Hepatitis B, also known as Serum Hepatitis, is a virus that causes liver disease. This virus can cause lifelong infections, scarring and fibrosis of the liver, liver cancer, liver failure and death. According to the Medical Research Council the Gambia, 10% of the adult population above 30 are living with hepatitis B virus and 10% of that infected population are long term (chronic) carriers of the virus.

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Anyone can get hepatitis B sometime during their lives but like the HIV/AIDS virus, you are at greater risk if you; have intercourse with an infected person, have multiple sexual partners, are homosexual, have ever been diagnosed with a sexually transmitted disease, are an injection drug user, live in the same house with someone who has lifelong (chronic) hepatitis B infection, are a healthcare or public safety worker who has contact with blood, are an infant born to an HBV infected mother, are a hemodialysis patient and lastly an infant/child or immigrant from areas with high rates of infection.

This is because the virus can be found in blood and to a lesser extent saliva, semen and other body fluids of an infected person. It is spread by direct contact with the infected fluid; usually by needle stick injury or sexual contact. Hepatitis B is not spread by casual contact.

The symptoms of the virus may appear six weeks to six months after exposure but usually within four months. The symptoms include fatigue, poor appetite, abdominal pain, fever, nausea, vomiting and occasionally joint pain, hives or rash. Urine may become darker in color and the jaundice (a yellowish discoloration of the skin and whites of the eyes) may appear. Adults are more likely than children to develop symptoms because they have a stronger immune response; however, some adults do not have any symptoms. In fact, infants have a 90%chance of becoming chronically infected because their immune system is not strong enough to fight the initial infection.

 

A safe and effective vaccine to prevent hepatitis has been present in The Gambia since 1986. The vaccine is recommended for people in high risk settings who have not already been infected and for infected mothers. It is recommended that all children be vaccinated against hepatitis B in the first day of life if possible along with their routine childhood immunizations beginning at birth. A special hepatitis B immune globulin is also available for people who are exposed to the virus

 

In The Gambia, the hepatitis disease burden is present in the population above 30 years because all children born after 1986 who visited the reproductive and child health clinic were vaccinated. The health sector has been providing vaccines for the children all across the country since it was noticed that the country has a high level of infected individuals. Health care workers and students in the health care sector are also vaccinated since they are exposed to bodily fluids.

 

However, we cannot be so sure that being vaccinated at childhood is enough. We cannot be sure that this vaccination renders us immune for our whole lifetime. This is where rapid hepatitis B test comes into play. It lasts only 15 minutes and detects the Hepatitis B surface Antigen Like HIV/AIDS again it is important we know our hepatitis B status. Only then can we know if we are safe from this virus.

All over The Gambia, there is sensitization on the prevention of HIV/AIDS in the form of health talks, billboards, newspapers etc. Permit my hyperbole when I say even babies know the HIV/AIDS virus. But most of us do not know that Hepatitis B is one of the causative agents of liver cancer in our brothers, fathers and sons. This may be because the former affects both sexes while the latter seems to have a male predilection. Two things they both share in common however are the facts that they have the same mode of transmission and they are both very dangerous and difficult to manage.

 

There are no special medicines that can fully cure a person that is acutely infected with HBV once the symptoms appear. Generally, bed rest is needed. Chronic carriers should avoid taking substances harmful to their liver as these actions make the liver disease worse. Chronic carriers should follow standard hygienic practices to ensure that close contacts are not directly contaminated by his or her blood or other body fluids. Carriers must not share razor blades, toothbrushes or any other object that may become contaminated with blood. In addition, susceptible household members, particularly partners should be immunized with hepatitis B vaccine. It is important for carriers to inform their dentist and health care providers.

 

In conclusion, hepatitis B virus infection may be either acute (self-limiting) or chronic (long-standing). Persons with self-limiting infections clear the infection spontaneously within weeks to months. Children are less likely than adults to clear the infection. This is why it is important for the population to be aware of the effects of the disease so as to allow their children to be vaccinated as soon as they are born. This is a step in the right direction to reducing the causative agent of the second most common cause of cancer in The Gambia in men after lung cancer.

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