Viral hepatitis is one of the leading killers across the globe, causing about 80% of cancer-related deaths and matching a death toll equivalent to Acquired Immunodeficiency Syndrome (AIDS) or tuberculosis (TB). At the early stages, the disease is symptom-free, but types B and C can trigger liver cirrhosis and cancer at the later stages if untreated. Data from the World Health Organization estimates that worldwide, 325 million people are living with Hepatitis B or C and between 130 to 150 million people globally have chronic Hepatitis C infection. The interesting thing about viral etiology of hepatitis isthat only few people are aware (9% for HBV and 20% for HCV) of their condition while the death tolls from these silent killershave continued to rise unabatedly.

The World Health Organizationagain estimates that hepatitis infections and their complications led to 1.34 million deaths in 2015, a toll roughly in line with HIV and tuberculosis. However while death due to HIV and TB appear to be under control, that due to viral hepatitis have continued to rise,recording a 22% mortality rise from 2000 to 2014. Although there are effective treatments and vaccines for viral hepatitis, there is very little money invested in getting these to patients – especially compared to malaria, HIV/AIDS and TB.Lack of access to testing and treatment hastherefore left millions of people at risk of a slow progression to chronic liver disease, cancer and death.

Hepatitis B problem is most acute in China, Malaysia and Southeast Asia with an estimated 115 million people in the region living with the virus. Second worst is Africa with estimated 60 million hepatitis B cases. Europe and the eastern Mediterranean region are afflicted with the most hepatitis C cases at 14 million and 15 million respectively. The number of people with HBV infection in Nigeria is unknown. However, there have been numerous prevalence studies in various populations in the country. Over 70% of the population shows evidence of past infection with the virus and 7.3–24% of the population has serological evidence of current infection (average 13.7%).

Thus, between 18 million and 20 million Nigerians are currently infected and approximately 5 will die of causes related to HBV infection. Extensive investigation of HBV genotypes in Nigeria showed that 95% of cases belong to genotype E. Analysis of HBV subspecies from 2 isolated rural communities in Nigeria revealed that individuals were infected with many different HBV variants. Among the dominant HBV/E strain, variant sharing was extensive, suggesting a very complex pattern of transmission. Numerous HBV strains may have been maintained within the population through socio-cultural practices such as scarification marks, sharing of sharp instruments for body piercing, and the use of non-sterile medical and surgical instruments. These practices have also been associated with HIV transmission in Nigeria.

HBV can be transmitted through percutaneous or mucosal exposure to infected blood or other body fluids. The transmission has been observed with numerous forms of human contact including perinatal/mother-to-child; household (nonsexual); sexual; needle-sharing; and occupational/health-care-related. The highest concentrations of infectious HBV are found in blood and serum. However, other body fluids, such as semen and saliva could also be infectious. Persons with chronic HBV infection are the major reservoir for transmission, although any person testing positive for hepatitis B surface antigen (HBsAg) is potentially infectious to both household and sexual contacts. Because HBV can remain stable and infectious on environmental surfaces for at least 7 days, transmission may occur indirectly via contaminated surfaces and other objects. Transmission from a chronically infected woman to her infant during delivery is efficient and is one of the most common routes of HBV infection worldwide. Perinatal transmission most often occurs during the birth process; in-utero transmission can occur but is rare and accounts for less than 2 percent of perinatal transmissions. The risk of perinatal infection is 5–20% in infants born to HBsAg-positive mothers and 70–90% if the mother is HBeAg-positive.

Studies in Nigeria have confirmed some of the routes already outlined. Further studies revealed a low prevalence in infancy and an increasing rate with age. In addition an incidence of 2.8% has been documented as the rate of HBV transmission from Nigerian females to their offspring as most infections in Nigeria occur through horizontal transmission. Various other studies have shown that blood transfusion is an important source of HBV transmission. Although CDC and a study in South Africa linked HBV transmission to tattoos and body cuttings/piercing, most studies in Nigeria found no link between traditional practices like, scarification, circumcision, ear piercing and HBV infection. Higher HBsAg prevalence noted among prisoners and rural dwellers were attributed to overcrowding and clustering while studies from north-central Nigeria indicates that unprotected sex is implicated in the transmission of HBV in the country. Despite the existence of a safe and effective vaccine, Nigeria has remained a hyper-endemic area for hepatitis B virus infection, with estimated 12% of the total population being chronic carriers. Vertical transmission is an important route of transmission for the virus infection and neonates who contract the infection will have an almost 90% risk of developing chronic HBsAg carrier state and chronic liver disease.

No specific therapy is available for persons with acute hepatitis B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a provider experienced in the management of chronic HBV infection. Therapeutic agents cleared for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease. In addition, two products have been approved for hepatitis B prevention: hepatitis B immune globulin (HBIG) for post-exposure prophylaxis and hepatitis B vaccine. HBIG provides temporary (i.e., 3–6 months) protection from HBV infection and is typically used as post-exposure prophylaxis as an adjunct to hepatitis B vaccination (in previously unvaccinated persons) or in persons who have not responded to vaccination. HBIG is prepared from plasma known to contain high concentrations of anti-HBs. Hepatitis B vaccination is recommended for all unvaccinated children and adolescents, all unvaccinated adults at risk for HBV infection (especially IDU, MSM, and adults with multiple sex partners), and all adults seeking protection from HBV infection. For adults, acknowledgment of a specific risk factor is not a requirement for vaccination.

HCV is treatable. However, immunoglobulins are ineffective in preventing infection due to the virus asthere is no really effective passive or active immunization processes. Consequently, behavioral changes and limiting exposure to high-risk situations offers the best chance of primary prevention of hepatitis C virus.


Article Source: http://theleaderassumpta.com/2017/08/19/viral-hepatitis-the-silent-killer/

always coming out to formulate rubbish just to create fear... Well, this is how they stay relevant , who cares

Issue is access to treatment for patients.

Something urgent needs to be done to make treatment accessible to patients with Hepatitis B and C viruses because many cannot afford treatment on their own in this country.

DrObum:
Issue is access to treatment for patients.

Something urgent needs to be done to make treatment accessible to patients with Hepatitis B and C viruses because many cannot afford treatment on their own in this country.

The treatment is also very expensive. You begin to wonder if it's just another means to make money.