The Hepatitis B Struggle in Africa: a glimmer of hope

Introduction to Hepatitis B

Hepatitis B is a disease caused by the Hepatitis B virus (HBV). A 2021 report by the WHO showed that Africa has the second-highest disease incidence in the world. This indicates how common the disease is in this region with about 81 million people living with the disease. According to the WHO, 60 million people within this region are chronically infected with hepatitis B even though the disease is preventable and treatable, and an overwhelming 90% of hepatitis B carriers do not get the adequate care needed. A minimum of 200,000 people also die yearly from it. All of these show the severity of this disease in the continent especially considering the fact that many who die from the disease are in the prime of their lives.

How is the disease transmitted?

There is an urgent need to scale up prophylaxis, screening, and treatment efforts within every healthcare system. Many infected people say they are unaware of how they got the infection and many others go on living with this infection without even knowing. However, transmission usually happens through various means such as at childbirth, via havingsexual intercourse with an infected person, through blood transfusion, sharing a razor, needle, or any other object that can pierce the skin with an infected person, and generally through contact with blood or body fluids like saliva or semen of an infected person. The most common route is from mother to child during childbirth, although the exact mode of transmission during the process is not fully known. Speculations are that it could be through the use of non-sterile needles or contact with traces of blood and body fluids during the process. While only about 5 % of chronic hepatitis B patients were infected after the age of 5, 95 % of chronic infections were at childbirth or before the child is 5 years of age.

 

Acute and Chronic infection

Most infections in adulthood are acute and can be managed quickly if diagnosis is expedited to prevent progress to the chronic stage. The Hepatitis B virus can be very discrete. Many acute infections can be asymptomatic while some others experience symptoms such as fever, nausea, vomiting, jaundice. These acute infections usually last for a short period if treated properly. Chronic infections are usually silent and slowly cause liver damage (cirrhosis) and liver cancer (hepatocellular carcinoma). It can last for months and years and happens when the infected person’s body has failed to clear off the hepatitis B virus. Considering the discrete nature of the virus, screening is of utmost importance for adequately managing patients.

Screening and monitoring

A report by WHO in 2019 showed that only about 10.5 % of estimated people living with hepatitis B were aware of their status and only 22% of the diagnosed had access to adequate care. The Sustainable Development Agenda 2030 of the WHO has a goal to globally eliminate Hepatitis and one of the major ways highlighted to achieve this is by scaling up screening, care and treatment. Early screening of the hepatitis B virus will enable quick management and prevent its development to the chronic stage. It is also important to monitor patients undergoing treatment in order to see the effect of their treatment and to carry on with the best possible treatment option. Continuous monitoring is especially important for treating people with chronic infections.

There are four stages of chronic infection; the inactive carrier phase, the negative HbeAg chronic hepatitis, the immune active phase, and the immune tolerant phase. Some serological biomarkers help to accurately diagnose hepatitis B at different stages. Some of these markers are HbsAg, HbeAg, HbcAg, and Anti-HbcAg. The DNA viral load is another important screening method. This viral load test will not only tell if there is an infection or not but will give information on the level of the virus in the host’s body. DNA viral load testing for hepatitis B is a vital tool that helps to indicate the stage of chronic infection and to track treatment and any antiviral therapy. With this tracking, patients can know when they are inactive carriers and are no longer infectious and the virus can be strictly monitored to prevent reactivation.

 

Hepatitis B DNA viral load test at Biologix

The use of this DNA test for Hepatitis B will strengthen the screening capacity of the healthcare system in Nigeria and will create room for better care management for patients following the WHO’s Sustainable Development Agenda 2030. In line with this, Biologix is introducing the viral load testing service for Hepatitis B in Lagos, Nigeria. This test will be a significant asset for medical practitioners seeking to manage hepatitis B patients. As a result of the discrete nature of the Hepatitis B virus, managing Hepatitis B is a process that requires careful monitoring and the new Hepatitis B DNA testing at Biologix is positioned to assist through that process.

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