Hepatitis B is Treatable and Preventable!

Know it, Get treated.

Across the country, millions of Ghanaians are living with hepatitis B. As many as three-fourths of Ghanaians living with the disease are unaware of their status and are not receiving care and treatment. Raising awareness about hepatitis B is crucial to effectively stemming the tide of new infections, ensuring that those affected receive proper treatment, and fighting any societal stigma.

“Hepatitis” means an inflammation of the liver. It refers to a group of viral infections that affect the liver. There are five main hepatitis viruses, referred to as types A, B, C, D, and E. The most common types are the A, B, and C. Of the three, only the B type has vaccination. Hepatitis B virus is the most common serious infection of liver, can lead to premature death from liver cancer or liver failure.

Hepatitis B virus is the cause of a growing number of new liver cancer cases and liver transplants world-wide. In Ghana, hepatitis B is a leading infectious cause of death; claiming the lives of millions of Ghanaian each year.

One in 12 Ghanaians is living with a chronic (life-long) hepatitis B, and one in four of those living with chronic hepatitis B will die from liver cancer or liver failure. The good news is that the effects can be avoided or prevented with appropriate education, monitoring and treatment.

How does hepatitis B spread?
In Ghana, the primary means of spreading the hepatitis B virus is mother to child infection. This can occur through sharing razors or toothbrushes which is common in our schools, unsafe procedures in medical settings, having sex with a hepatitis B-infected person without using a condom, re-using needles for tattoos, piercings, or injecting drugs.

Hepatitis B is not spread through Food and Water.
There are myths about how you get hepatitis B. It is important to understand that hepatitis B is not spread through sharing food or water, sharing eating utensils or drinking glasses, casual contact, coughing or sneezing, hugging or kissing and breastfeeding. There is no reason to distance oneself from an individual infected with the hepatitis B virus. Individuals living with chronic hepatitis B should not be excluded from work, school, or other daily activities.

What are the signs and symptoms of hepatitis B?
Most people don’t show any symptoms at all. So if you think you might have been at risk it is important to see a medical practitioner and get tested, though you might look healthy and feel good. The signs and symptoms of hepatitis B include nausea, lack of appetite, tiredness, muscle, joint, or stomach pain, fever, diarrhea or vomiting, headache, dark urine, light-colored stools, and yellowing of the skin and jaundice. People who have such signs or symptoms generally feel quite ill and might need to be hospitalized.

How serious is hepatitis B?
Hepatitis B is dangerous because there are often no symptoms. Even liver blood tests may be normal. By the time symptoms, such as abdominal pain or jaundice (dark urine and yellow discoloration of the skin or eyes) appear, it is often too late for treatment to be effective. But this is not a rule. The course of the disease can be different from person to person, and it depends on whether you have an acute or a chronic infection.

A new infection (acute hepatitis B) may go away on its own in the first six months. Most people do not need any therapy at the early stage of the disease. Thus, if an adult gets infected with the hepatitis B virus, there is a 90 percent chance the person’s immune system (the body’s defense system) will fight the disease off in the first six months (the acute phase) and no treatment might be necessary.

However, six months after contracting the virus, those 10 percent who cannot fight the disease by their immune system will develop a long-term infection (chronic infection). This means that the intense battle that goes on inside the body during the acute stage between the virus and the immune system has been won by the virus. If left unchecked and unmonitored, infection can eventually develop into a serious liver disease, including liver failure and liver cancer. Again, this is not a rule. Chronic (long-lasting) hepatitis B can also have a mild course for many years. So it is very important that chronic carriers of the virus know their status and that they are monitored by their doctors regularly (every 6-12 months) to see if they need treatment to control the virus.

When it comes to newborns, the odds are different. Only 10 percent would be able to clear the virus from their bodies, while the remaining 90 percent would develop chronic hepatitis B.

Also, a person’s immune system might be weakened by old age and co-infection with other diseases, such as HIV/AIDS. In this case, hepatitis B becomes chronic more often. Chronic hepatitis B requires management, just like diabetes!

How do I protect myself against hepatitis B?
To protect oneself against the hepatitis B virus, one should get vaccinated. Vaccination for hepatitis B comes in 3 shots (please make sure you get all of these shots):

1st injection: day 0
2nd injection: 1 month later
3rd injection: 6 months after the 1st injection

Can the vaccine for hepatitis B have side effects?
Most people tolerate the vaccine very well. One in 10 people might have some side effects for a while, and feel as if they have had flu. It is very rare that a person will have long-lasting, serious health problems after the vaccine. Even in a rare case where a person can experience serious side effect, experts are not sure if the vaccine is to be blamed or if something different was going on at the same time in the person’s body.

How long does it take before the vaccine shots really protect me?
Most people are protected sometime after the second vaccination. The third shot helps to make the protection long-lasting.

I had sex with a new partner yesterday. Afterwards, he told me he had hepatitis B! I am afraid I might have been infected. What should I do now?
Sex is the main route of getting infected by the hepatitis B virus. Consult a medical practitioner and get tested IMMEDIATELY! Don’t wait any day longer. If you think you have been infected in the last few hours, your doctor can give you a special vaccine (passive vaccine/antibodies) to protect you from contracting the virus. This vaccine only works if you receive it 24 to 48 hours after infection.

To be fully protected against hepatitis B in the future, one also needs to get a different vaccine (standard vaccine), which is an active vaccine and stimulates the immune system to protect itself against future infections.

The passive vaccine is for emergency needs only. Thus, when one needs protection FAST! This vaccine has some protecting agents from healthy, vaccinated individuals that works fast, but doesn’t last very long as it is not one’s own protecting agents doing the job. The passive vaccine doesn’t protect one any longer than three months after vaccination.

On the other hand, the active vaccine, which is a standard vaccine (3 shots), teaches one’s body to protect itself against the hepatitis B virus. The three injections should give one a long-lasting protection against the virus.

My doctor just told me that I have hepatitis B. What should I do when I get home? My family has not been vaccinated yet. How can I avoid infecting my husband and my children until they get vaccinated?
If the results of your hepatitis B tests had been positive for longer than six months, then, it suggests that you have a chronic (long-lasting) hepatitis B infection. Consult your medical doctor to find out if you would need treatment.

Most people with chronic hepatitis B can live a normal life. However, it is important to know what to do to avoid infecting others – you should inform your close ones (family members and sex partners) so that they can get vaccinated to protect themselves.

I have chronic hepatitis B. Do I need treatment?
Not every individual with chronic hepatitis B infection would need treatment. But if one’s ALT level is elevated, treatment with antiviral medication may be appropriate. Be sure to review all medications with your medical doctor, as some over-the-counter or herbal medications can injure your liver. Ask your medical doctor about FDA-approved treatments. Treatment does NOT cure hepatitis B; appropriate treatment can reduce the risk of liver cancer and liver failure. Treatment controls the virus. It can turn a “bad” chronic hepatitis B into a “peaceful” hepatitis B. It can stop the virus from attacking your liver and causing damage. Only your medical doctor can tell if your chronic hepatitis B is “bad” or “peaceful”, if it is attacking your liver or not. You cannot feel the difference.

If one’s virus is “peaceful” (that is, if the virus is not currently causing any damage to one’s liver), one does not need treatment. Having said that, it is always important to monitor one’s condition every 6 months, as a “peaceful” hepatitis B can suddenly become “bad”. Then, everything changes, and one needs treatment. One’s doctor is well-placed to exactly explain one’s situation. Some patients may need therapy. Others just need their conditions to be monitored. The decision to treat a carrier depends on the amount of virus one has in his/her blood (HBV DNA), and what the virus is doing to one’s liver. One also needs to check the status of one’s liver enzymes (especially ALT).

Treatment for hepatitis B is expensive and I cannot afford it. So why should I get tested?
Though you may not be able to afford to pay for treatment, it is extremely important you get tested and here are the reasons why. First, not everyone needs treatment. While some people may need medication to control the hepatitis B virus, others only need to be monitored. Second, once you know your hepatitis B status, there are things you can do to protect yourself: Avoid alcohol consumption! Just imagine you have a fire burning in your liver (inflammation). Now, what do you think will happen if you add alcohol to the fire? Adopt a healthy diet. Stop smoking. Have protected sex (use a condom!). Take great care of cuts and wounds (make sure you clean after any blood spillages). And tell your family to get vaccinated!

When should my baby receive the vaccines?
At birth: your baby should receive a shot of the hepatitis B vaccine and a shot of H-BIG.
1-2 months old: your baby should receive another shot of hepatitis B
6 months old: your baby should receive his last hepatitis B shot

Can I breastfeed my baby if I have hepatitis B?
Yes, provided your baby get a shot called H-BIG and a shot of hepatitis B vaccine within 12 hours after birth. Then it is OK to breastfeed the baby. Hepatitis B is not transmitted through breast milk! It is important to take good care of your nipple areas to prevent cracking and bleeding.

Can I breastfeed my baby if I have hepatitis B and am taking hepatitis B medication?
If you take any medication for hepatitis, please DON’T breastfeed your baby.

What must I do to support?
We must work to reduce the stigma surrounding hepatitis, and to ensure that testing, information, counseling, and treatment are available to all who need it. These goals can be achieved by raising public awareness of this life-threatening disease. The hard work and dedication of health-care professionals, researchers, and advocates will help bring us closer to this goal. We renew our support for those living with hepatitis, and for their families, friends, and communities who are working to create a brighter, healthier future.
We must make sure that this “silent epidemic” does not go unnoticed by health professionals, government or by communities across the country. The World Health Organization (WHO) has declared 28th July of every year as the World Hepatitis Day. World Hepatitis Day is an annual event that provides international focus for patient groups and people living with hepatitis B and C to raise awareness and influence real change in disease prevention and access to testing and treatment facilities. World Hepatitis Day is one of only four disease-specific official health days recognized and supported by the WHO, with 193 countries committed to participating.

To mark the World Hepatitis Day in Ghana, we are organizing the 2012 World Hepatitis Day in the Ashanti Region, Greater Accra Region, and Northern Region.

Your investment and support would be vital to raising awareness of the devastating effects of viral hepatitis and the existence of preventive programmes in the country. Therefore, we request that you join hands with us as a sponsor or volunteer for the event.

It’s closer than you think. This is hepatitis……………..
Know it, Get Screened, Get Tested, and Get Vaccinated!
Let’s Unite Against Hepatitis In Africa. Join us on 28th July, 2012.

Theobald Owusu-Ansah
Regional Board Member for Africa, World Hepatitis Alliance, UK
President and Founder, Theobald Hepatitis B Foundation, Ghana
Email: theobald2003@yahoo.com
Telephones: +233-247-093-893
+233-26-826-9214