HEPATITIS B – A perilous liver disease that cannot be tolerated

Scientific evidence proves that the liver is the largest and hardest working organ in the body of every human. It performs over 500 functions daily to ensure sound and a well-balanced human health. The liver is derived from the word ‘live’ indicating life survives on the liver. The state of the liver has a direct bearing on human health and life expectancy. 

However, the liver isn't often the subject of much cocktail party conversation. People love to talk about their blood pressure level, cholesterol level, sugar level, body mass index and diet either at home, workplaces or wherever they meet as a group. But how often do you hear someone say, ‘My Liver Function Test looks good all the time.’

                                             

The liver gets very little recognition from the general public and is in fact, often abused by most people and especially modern diets and bad lifestyles.

According to some hepatologists, there is up to 99% chance your liver is not performing at its very best. In fact, this organ manufactures a full quart of bile daily to breakdown fat. It’s also responsible for filtering harmful toxins and substances out of nearly 100 gallons of blood daily and produces more than 13,000 crucial chemicals and hormones.

The liver is also responsible for regulating blood sugar levels, cholesterol, hormones and also stores essential vitamins and minerals. It is also responsible for detoxifying all internal and external environmental pollutants.

However, one must know that a number of diseases can afflict the human liver, including hepatitis –A form of liver inflammation; Liver cancer; Cirrhosis –chronic inflammation often caused by alcohol abuse, chronic hepatitis B and C; Diseases of the bile ducts and Fatty liver disease that can ultimately lead to liver failure. Having hepatitis means that the functions of the liver have been compromised and life expectancy is being reduced.

So, in the wake of increasing deaths emanating from the attack of for instance hepatitis B (the commonest liver disease) which can be acquired through various forms including (unprotected sex, transfusion of contaminated blood, body fluids, sharing of tooth brushes, contaminated needles and syringes and tattooing/tribal marking), this article brings to bear, the debilitating effects of the disease, how to seek treatment and what can be done to prevent further spread of the epidemic which if not tackled with a sense of urgency, could seriously compound the fight against HIV and AIDS! The truth is, an HIV or AIDS patient with hepatitis B has very little chance of surviving, according to medical doctors.

Causes of hepatitis

Hepatitis is most simply defined as an inflammation of the liver. Hepatitis has various causes.  According to different research outcomes, it can come from a viral infection, an attack by parasites, a transfusion of contaminated blood, or unhealthy substances that are introduced into the human body like alcohol, drugs, or toxins. Hepatitis may or may not be a serious health threat. However, hepatitis in certain circumstances can become chronic and can even lead to liver failure and death when it’s detected very late. Many laboratory investigations have revealed that there are several types of hepatitis, and they are given alphabetical names.

Types of hepatitis

Hepatitis A: It’s a liver disease caused by the hepatitis A virus. It is generally spread by coming into contact with the faeces of an infected person. Hepatitis A is highly contagious, but it doesn't cause chronic liver disease. A vaccine for Hepatitis A is available.

Hepatitis B: It’s called serum hepatitis. Hepatitis B is a blood-borne viral disease caused by the hepatitis B virus or HBV and is one of the most common infectious diseases in the world. It can be acute or chronic. Most healthy adults (90%) who are infected will recover and develop protective antibodies against future hepatitis B infections. A small number (5-10%) will be unable to get rid of the virus and will develop chronic infections. Unfortunately, this is not true for infants and young children – 90% of infants and up to 50% of young children infected with hepatitis B will develop chronic infections. Therefore, vaccination is essential to protect infants and children. The virus is passed from an infected person to another through blood and body fluids like semen and breast milk. Symptoms of the disease may include tiredness, nausea and stomach pain and weight loss. They also can include not feeling hungry or feeling pain in the joints. In some people, the skin and eyes may become yellow. A person’s urine may be dark coloured and the stools or bowel movement may be whitish. Only about 30 percent of people with hepatitis B have any symptoms. A vaccine for Hepatitis B is available and can protect one up to ten years.

Hepatitis C: It’s a liver disease caused by the Hepatitis C Virus or HCV. HCV infection sometimes results in an acute symptomatic illness. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong chronic condition that can lead to cirrhosis of the liver and liver cancer. Unlike HBV which is transmitted sexually and through other means, HCV is only transmitted through contact with the blood of an infected person. According to the World Health Organisation (WHO), about 130 – 170 million people are chronically infected with HCV, and more than 350,000 people die from hepatitis C-related liver diseases each year. HCV infection is curable using increasingly effective antivirals. Despite ongoing research, there is currently no vaccine to prevent HCV infection. It is estimated that 3 – 4 million people are infected with HCV each year. HCV infection is found worldwide. Countries with high rates of chronic infection are Egypt (22%), Pakistan (4.8%) and China (3.2%). The main mode of transmission in these countries is attributed to unsafe injections using contaminated equipment. There is no vaccine to prevent Hepatitis C.

Hepatitis D: It’s caused by the Hepatitis D virus. The Hepatitis D virus needs the Hepatitis B virus to survive. Sometimes people with Hepatitis B also get Hepatitis D because both are passed from one person to the other through blood and body fluids. 

Hepatitis E: This is caused by the Hepatitis E virus. Similar to the hepatitis A virus, it is spread by coming into contact with the faeces of an infected person. 

Hepatitis G: Not much is known about the Hepatitis G virus or even if it causes illness. It may be transmitted through contaminated blood in blood transfusions. 

However, medical doctors advice persons who suspect they have any of the types of hepatitis, to go to an approved medical laboratory/hospital for samples of their blood to be taken for a test. When the test result is reactive or positive, your medical doctor will ask you to do what is called viral load; (Viral load is the amount of virus in the blood). A lesser amount of virus means there is less risk for serious liver disease. If the results of the viral load test shows you have more virus, you may be asked to do a liver function test to determine how healthy your liver is before any treatment is given to you depending on how serious your case may be. A person with HBV is given some of the most effective drugs (lamivudine, lyvomyn, heptovit, interferon and antivirals) for the treatment of the disease. But if the laboratory test result for the disease is non-reactive or negative, you will be asked to take the hepatitis B vaccine for protection. However, HBV cannot be spread by casual contact, such as holding hands, sharing eating utensils or drinking glasses, breast-feeding, kissing, hugging, coughing, or sneezing.

A recent survey conducted by the Pharmaceutical Society of Ghana revealed that an estimated 4 million people in Ghana have HBV. It is imperative therefore, to create nationwide awareness about the importance of the liver and its implications on the health of mankind. It is important to note that, a liver problem like HBV is dangerous – and if government is not alarmed, it is certain that it is waiting for a major epidemic explosion or health disaster. 

Steps government should immediately consider

The government through the Ghana Health Service (GHS) should immediately embark on a free nationwide vaccination of persons who have not yet been infected with the HBV and also make available vaccines at the various public hospitals across the country for newly born babies to be vaccinated. The disease should be taken care of like other diseases such as HIV and AIDS, malaria, CSM, guinea worm, and among others, coupled with public education in the electronic media. Anything short of this means that the 4 million figure is bound to increase astronomically in the next few years.  

Treatment of HBV is very costly than HIV. In fact, the cheapest drugs one can get for the treatment of the disease include lamivudine, lyvomyn, heptovit, among others needed to be taken every month and perhaps for a lifetime. The most effective treatment could cost as much as between GH¢5,000.00 and GH¢10,000.00. Thus, government should seriously consider including some of the medications or treatment of HBV in the National Health Insurance Scheme.

Besides, the GHS should conduct extensive research on HBV which is the commonest liver disease currently in the system so as to determine the number of persons living with the virus so that an effective policy by government could be rolled out towards its fight or eradication. This is because several laboratory results in private and public health institutions indicate that many people have contracted the disease.

Furthermore, the GHS should consider establishing something similar to the Ghana AIDS Commission and charge it with the mandate and responsibility of controlling or fighting the disease nationwide.

Meanwhile, W.H.O global projections suggest that 10-30 million people will become infected each year by HBV, while an estimated 1 million people will also die each year from the disease and its complications. Approximately 2 people die each minute from HBV. Having Hepatitis B means that your liver is not hundred percent functional and life expectancy thus reduces at a very fast spate.