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Wednesday, May 19, 2004
Hepatitis B: The facts
By Henrylito D. Tacio
Health 101
IF YOU'VE been feeling out of sorts, have lost your appetite (especially for cigarettes), have a low-grade fever and a yellow hue to your skin and the whites of your eyes, you almost certainly have hepatitis -- an infection of the liver.
Medical science has discovered six different kinds of hepatitis and a different virus causes each of these. Among the six viruses, the most common and more serious disease is hepatitis B. More than two billion individuals alive today have been infected at some time in their lives with the said virus, also known as HBV.
Approximately 350 million people around the world are chronically infected with HBV, according to the Geneva-based World Health Organization (WHO).
These chronically-infected persons are at high risk of serious illness and death from cirrhosis of the liver and liver cancer, diseases that kill about one million chronically-infected persons per year worldwide. Liver cancer caused by HBV infection is one of the top three causes of cancer death in much of Africa, Asia, and the Pacific Basin.
In the Philippines, an estimated 1.4 million people are highly infectious carriers of HBV. Every year, at least 1.6 million get sick of the disease. Of this total, two percent do not recover and become chronic carriers.
"At the earliest, patients recover after 10 weeks," explains Dr. Ernesto Domingo, head of the Liver Study Group of the University of the Philippines.
"Most recover only after six months. If you don't recover after six months, you become a chronic carrier."
If you care to know, our country has been identified as one of the 20 countries in the Asia-Pacific region with a high incidence of hepatitis B.
A country is considered to have a high incidence of the disease if at least 10 percent of its populations are infected.
My notes said that HBV infection leads to one of three outcomes in man. An infected individual may die of fulminant hepatitis - a rare form of liver disease that frequently results in death - within days or weeks after onset of disease, may recover after showing some symptoms (although some sufferers report no symptoms) and develop lifelong immunity, or may develop chronic infection, a persistent infection which usually lasts for life.
The age of infection is the major factor in determining the outcome of HBV infection, studies claim. Fewer than 10 percent of children under 5 years of age are sick when they first become infected, but 80-90 percent of infants infected during the first year of life, and 30-50 percent of children infected between 1-4 years of age develop chronic infection. By comparison, 30-50 percent of adults are sick when they first become infected, but only 2-5 percent develop chronic infection.
The UN health agency says HBV is transmitted by either skin puncture or mucous membrane contact with human blood and other infectious body fluids. The virus is found in highest concentrations in blood; 10 to 100 times lower concentrations are found in saliva, semen and vaginal fluid. The main ways HBV is spread are prenatal (mother to baby), child-to-child, during sexual contact (vaginal, anal and/or oral), and through unsafe injections and blood transfusions. The HBV is not spread by air, food, water and breastfeeding.
In developing countries like the Philippines, spread of HBV from child-to-child accounts for most HBV infections. Child-to-child spread most likely happens as a result of contact of skin sores, small breaks in the skin, or mucous membranes with blood, skin sores, or perhaps saliva.
Spread from inanimate objects, such as sharing of wash towels or toothbrushes, may also occur because HBV can survive for at least 7 days outside the body.
Unsafe injection practices, particularly those being employed by drug addicts, are a major source of HBV transmission worldwide. In addition, blood transfusion can be a major source of HBV transmission in countries where the blood supply is not screened. Inadequate infection control practices, including reuse of contaminated medical or dental equipment, failure to use appropriate disinfections and sterilization practices for equipment and environmental surfaces, and improper use of multi-dose medication vials, can also result in transmission of HBV.
HBV is efficiently spread by sexual contact, which can account for a high proportion of hepatitis B cases among adolescents and adults in countries with a low and intermediate prevalence of HBV infection. In countries with a high prevalence of HBV infection, sexual transmission does not account for a high percentage of cases because most persons are already infected during childhood.
Medical experts say that those who are at high risk of the Hepatitis B virus are children below five years old, health care professionals who are usually exposed to blood, blood donors, army personnel, prisoners, homosexuals and hospitality girls.
(May 19, 2004 issue)
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