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Hepatitis: WHO, experts call for more awareness

As the world marks Hepatitis Day tomorrow,MOTUNRAYO JOEL writes that experts seek more awareness campaigns about the deadly disease

Hepatitis which is the inflammation of the liver has been proven by experts to be one of the deadliest diseases on earth. Many experts have even described it as deadlier than the dreaded Human Immunodeficiency Virus.

A consultant/physician, gastroenterologist, Dr. Sylvester Nwokediuko, who spoke withSUNDAY PUNCH, linked this opinion to the fact that the virus that causes Hepatitis B is 100 times more infectious than HIV.

“Some of the reasons why hepatitis is deadlier than HIV are because the virus that causes hepatitis B is 100 times more infectious than HIV. Secondly, in terms of the magnitude of the problem, that is hepatitis, many more people have hepatitis B. it has been estimated that 20 million Nigerians have hepatitis. Thirdly, based on its natural history, hepatitis B can cause more destruction of the liver leading to liver cirrhosis and cancer. These two conditions are not easy to treat, a patient with cirrhosis would need to undergo liver transplant. Unlike hepatitis, HIV affects the immune system, and there are people who have a strong immune system. Hence, it is possible for them to carry on living their normal lives even with the virus in their system. Hepatitis generally causes more morbidity.”

Meanwhile, the World Health Organisation in its 2014 fact sheets estimates that two billion people have been infected with the hepatitis B virus worldwide. It, however, puts the figure of those chronically infected with hepatitis C at 170 million.

Reacting to the statistics, Nwokediuko acknowledged the figures disclosing that 400 million out of the two billion, have chronic infections that require evaluation and treatment,

He continued, “Between 600,000 to one million people worldwide will die of hepatitis B complicated related illnesses yearly. However, in Nigeria, because we have a poor record-keeping skill, it’s difficult to put a figure to the number of Nigerians that will die annually, but close to 10 per cent of deaths in teaching hospitals and the medical centres are as a result of chronic liver diseases. Hepatitis is one of the infections that cause liver disease.”

The President, Society for Gastroenterology and Hepatology, Nigeria, Prof. Olusegun Ojo, explained that inflammation of the liver could also be caused by a viral infection.

He said, “A range of viruses can infect the liver but a peculiar group have predilection for the liver, selectively infecting it whenever they get into the human body. These viruses are referred to as the hepatotropic viruses and they are denoted by alphabets A to E in literature.

“Although, certain non-hepatotropic viruses such as the yellow fever virus are capable of infecting the liver alongside other organs, they are not considered to be agents of viral hepatitis because they do not cause liver-specific disorders. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.”

He continued: “Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.

“Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.”

However, according to Nwokeduiko, any infection that lasts for more than six months becomes chronic and chronic hepatitis may lead to liver cirrhosis and liver cancer if untreated.

“It’s these complications that may shorten one’s life,” he warned.

With the serious nature of this disease in its various forms, it is sad that the level of awareness on its existence and causative factors are, according to Ojo, low in Nigeria.

“There is a dearth of information on hepatitis in Nigeria. There needs to be increased efforts at educating communities on prevention of spread among children (through harmful acts of native surgeries such as tribal markings, genital mutilations and so on). Vaccination is not extended to schoolchildren but new born through the pentavalent which shouldn’t be so.”

He called on the Federal Government to put more effort in generating measures that would educate people about the infection.

“The Federal Government needs to increase the knowledge of hepatitis B among the general public. Educating the general public regarding hepatitis B, including how it is transmitted, prevented and treated, will result in more people reducing or eliminating their risk of infection. It would also improve their chances of getting screened, diagnosed and vaccinated, whatever the applicable scenario in the individual case. By raising awareness about the disease, the burden will reduce in the population over time.

“At the same time, Nigerians should take steps to determine their HBV and HCV statuses by getting screened in hospitals and medical laboratories. If negative, they should seek to be vaccinated and, if positive, they should ask to see hepatologists, specialist physicians who are knowledgeable and conversant with further testing and treatment.”

Ojo also highlighted various treatment options available for the deadly disease.

“On the treatment of hepatitis B and C, antiviral agents active against HBV exist. However, drugs active against HBV are not widely available or utilised in persons infected with HBV. HCV on the other hand is generally considered to be a curable disease but for many persons this is not a reality.”

An online site, www.dnaindia.com, claims scientists have revealed that a combination drug therapy cures chronic hepatitis C in the majority of patients co-infected with both HIV and hepatitis C.

However, the WHO is not treating the disease with kid gloves as it has called for intensified campaign against it. The theme for this year’s World Hepatitis Day is, ‘Think Again.’

In a statement, WHO called for an increase in awareness and understanding of viral hepatitis, its symptoms, treatment and prevention.

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