A friend of mine just called me now crying and confused. He works for a good telecom company in Kano and briefly had an affair with a lady briefing for about 6 month early this year. He went for a medical screnning to go to Cyprus for further study after he got a scholarship but was diagnosed with Chronic Hepatitis B infection (don't know much about this but he said he was told there is no cure for it!!!). He was refused the visa based on health ground.
His problem now is that he is married and he is confused as to where he could have got the infection. She compelled the lady he had affair with and she tested negative. This friend is an innocent type who don't run shows with girls and said he has affair with only the lady. His confusion is, could he had contacted the virus from his wife that they are married for about two years now? If he got it from the wife, how come he didnt transfer it to the lady? How will he tell the wife? How will he ask the wife to go for test without her suspecting? As it is now, its like it is the person that discovered it first that transmit it.
How can the whole stuff be managed without destroying his marriage and relatiosnhip with friends, families and in-laws? There seem to be low awarness about this virus but doctors said it attacks the liver.
Please it is not time to cast blame and advise on use of protection etc. He needs serious advise and help to manage his life henceforth.
Thank you. Useful comments please.

A diagnosis of chronic hepatitis B is one that which defies any medical cure science can provide at the moment.
As opposed to ACUTE hep B infection, which the body's immune system may be able to clear in few months, CHRONIC hep B is one that has remained in the patient for at least 6months and continues to reside in the patients blood and liver.
The problem here isn't that there is no immune response but just that the immune sytem cannot clear out the virus. The immune response within the liver attacks the virus but also damages liver cells in the process.
When this immune response continues over a long period, the liver tries to replace damaged cells. The cell replacement is faulty because of scarring and leads to formation of multiple liver nodules -- called LIVER CIRRHOSIS.
Liver cirrhosis over time could also lead a number of other pathologies, including HEPATOCELLuLAR. CARCINOMA (cancer).
Now about tranmission, your friend should not be too puzzled about how he contracted hepB it is spread by
-Se.xual intercourse
-Hypodermic Needle sharing (IVDA)
-Infected Tatoo needles
-Tranfusion with infected blood and blood products
-Infected barbers clippers
He should ask his wife to get tested although, he should be too suprised if she is negative. Some individuals are more immuno-competent than others. She could have had the infection but cleard it out. It is unlikely he contracted it from his mistress whois negative anyway.
Now the treatment for chronic HepB is palliative rather than definitive. Palliative in that he can be given antivirals eg tenofovir but these only slow the replication and do not eliminate the infection.
Hopefully, a cure for chronic hep B is in the pipeline, though a vaccine already exists more than 30 years now.
HepB transmission can be prevented by using a barrier during sex - condom. There are also antiviral creams which you may use in combination with that to further ensure safety.
Contact totalhealthng21@gmail.com for more info or click our signature below.

It is almost impossible for him to find out who he got the hepatitis B virus from. It could be from his mother during his birth, from people he played with as children, blood/blood product transfusions, contaminated needles and any of his previous sexual partners.

This virus is very infectious (ie can be easily transmitted) and particularly dangerous if you get it as a child. Most chronic carriers got the infection in childhood. 90% of adults with a normal immune system clear the acute infection and do not become chronic carriers. This is the reason developed countries routinely immunized all their children against hepatitis B with the first vaccine given within 24hours of birth. It is very contagious even from cuts in playground.

Since this is his first test, he can repeat it 6months later to see if the test is still positive. If he is, then he definitely has chronic hepatitis B infection (about 10% of Nigerians are infected).

The next thing to do will be to test his wife and children. If they are not infected now, they be immunized IMMEDIATELY so they do not get the infection from him. This virus is very CONTAGIOUS.

If his wife is infected, any future children they have can be given the vaccine beginning at birth to protect the baby. The vaccine (given in 3 doses preferably with another vaccine called HBIG) is very effective in preventing mother-to-child transmission of the virus that occurs during child birth.

Because all infected newborns look normal at birth and during childhood/adolescents, the only way to know if they are infected is to do the test (HBsAG, anti-HBs). Children who are infected are more likely to have chronic liver disease and liver cancer which does not show up until they are about 20 or 30 years old.

For your friend, he should have his doctor do a liver function test and see if his liver is already showing signs of damage. Although he is at risk for chronic liver disease/failure and liver cancer, there are ways (viral drugs and interferon) to prevent chronic carriers from these complications. They are expensive and probably not available in Nigeria.
Good luck.

Thank you for the replies.
I think the major problem here is what the reactions of his family members (wife especially as the child is still young). Because this guy stays away from the family, it will be difficult for the wife to believe that the man has been probabily been sleeping around with women and has now infected her and the kid. The guy is also thiking perhaps the wife also might have infected him, so there is more of blame trading that will happen here that may possibly lead to the break down of the family.
I think his major concern first is how to handle this situation so it does not get out of hand. Its a happy, happy family and this is definitely a great test on them.

In these situations, telling the truth is the best way to go and his doctor can help explain to his wife that it is impossible to determine when and where he got hepatitis B virus from unless he had a test in the past that was negative. It is unlikely that his current sex partners infected him even if he got it through having sex.

I will stress that most of the adults who have chronic hepatitis B infection got it when they were below the age of 5years. If you get infected as an adult and you have a normal immune system, the chance that you will become a chronic carrier in slim, about 10%.

I usually tell my patients that their time is better spent facing this health problem that has the potential to make everyone in the family very sick including future children they may have than looking for who infected them because that is almost impossible. i will have to test their mother, siblings, playmates, all past sexual partners etc.

His wife MUST be tested immediately and if negative given the hepatitis B vaccine to prevent her and their future children form getting infected.

Below is a list of how hepatitis B virus is spread in no particular order:

Transfusions of blood and blood products (not common in the United States)

Direct contact with blood or body fluids(did he treat a friend's wound without gloves?)

Sexual contact with an infected person

Tattoo, pedicure etc with unclean needles or instruments

Shared needles during drug use

Shared personal items (such as toothbrushes, razors, and nail clippers) with an infected person (why we test siblings and house hold members)

During childbirth if the mother is infected.