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Hepatitis B: A Silent Killer

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Hepatitis B is a potentially life-threatening infection of the liver caused by the hepatitis B virus.  Hepatitis B often causes damage to the liver without the individual knowing as it may not produce symptoms in its early stages. In some persons, it progresses into a chronic disease that is incurable and potentially fatal. Hepatitis B can be prevented through vaccination or kept controlled with antiviral medication.

Mrs. Johnson hastily drove down to see her family physician, Dr. Emeka, after her husband revealed that he had been diagnosed with liver cancer. Further investigations had revealed that he had longstanding hepatitis B.

Mr. Johnson had been in and out of hospitals for a couple of months now; receiving treatment for malaria-like symptoms (loss of appetite, vomiting and nausea, weakness, fatigue, and body pain), which never got better. After a few months, the symptoms began to get worse and he began to lose weight. He also noticed his abdomen getting bigger and increasingly painful. Mrs. Johnson noticed a yellow tinge in the white part of his eyes. “This must be more than malaria,” Mrs. Johnson thought. She was the one who advised her husband to return to the hospital for the fourth time.

Doctor checking blood samples

At the hospital, the new doctor ordered some blood investigations and an ultrasound; Mr. Johnson was admitted and placed on some initial medications. This time, results came back positive for liver cancer and chronic hepatitis B.

Liver cancer is cancer which begins in and affects the liver cells. In its early stages, affected persons usually do not have signs and symptoms. However, when symptoms appear, they include malaria-like symptoms such as:

  • Loss of appetite
  • Unexplained weight loss
  • General body weakness
  • Nausea and vomiting

It also produces other symptoms such as:

  • Abdominal pain
  • Abdominal swelling
  • Yellow discoloration of the white part of the eyes (jaundice).

“So, what caused the liver cancer?” Mrs. Johnson asked the doctor with tears in her eyes.

“While the cause is unknown in many cases, there are several risk factors including hepatitis B, inherited liver disease, and excessive alcohol intake,” Dr. Emeka said. “Your husband’s was caused by hepatitis B, one of the most common causes”

What is Hepatitis B?

Hepatitis B is a potentially life-threatening infection of the liver caused by the hepatitis B virus. The virus can be transmitted through contact with blood and bodily fluids of infected persons, as well as from a pregnant woman to her baby. Hepatitis B is a global problem. As of 2015, the World Health Organization reported that 257 million people were living with hepatitis B; and that same year, hepatitis B killed more than 887,000 people – mostly from liver cancer and cirrhosis.

“How did he get it,” asked Mrs. Johnson.

There are many ways Mr. Johnson may have contracted the virus. These risk factors include:

  • Unprotected sexual intercourse
  • Having multiple sexual partners.
  • Needlestick injury
  • Intravenous drug use
  • Tattooing
  • Sharing razors and other sharp objects

Once contracted, the virus incubates and multiplies in the body for an average of 75 days, after which it may produce symptoms. In 5 out of 100 adults with hepatitis B, the disease progresses into a chronic state – this is what happened to Mr. Johnson.

“How come we did not know; What are the symptoms of this infection,” asked Mrs. Johnson.

Just as in liver cancer, most individuals with hepatitis B do not have any symptoms early in the disease. However, after the incubation period, some people may experience the same malaria-like symptoms listed above. As a result, the condition can be easily mistaken for malaria or other acute febrile illnesses.

In most adults, the disease may resolve spontaneously; however, those who develop chronic hepatitis B may have to be placed on certain medicines for the rest of their lives since it has no cure. These medicines include antiviral drugs – which suppress the virus.

Consequently, prevention is crucial in hepatitis B and the hepatitis B vaccine is the mainstay of prevention. The vaccine is administered in a 3-dose schedule. This vaccine series is recommended for those at risk of the infection, including close-contacts of infected persons, people with multiple sexual partners, healthcare workers, and travelers to endemic areas. Even if you do not fall into this high risk groups, you should ask your doctor about hepatitis B. It may be advisable to get tested at least. Also ask your children’s doctor to see whether they should be vaccinated or checked out.

In adults who ultimately develop chronic hepatitis B, liver cancer may just be a short while away. Liver cancer progresses rapidly and is only caught when the disease is advanced.

Still depressed by the news, Mrs. Johnson asked if there was anything that could be done to save her husband.

“Treatment for liver cancer depends on the stage of the disease – surgery, chemotherapy, or radiotherapy, or a combination of these may be used; but unfortunately, liver cancer has a very poor outcome,” Dr. Emeka said.

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