Monday, May 29, 2006
Facts on Hepatitis B
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).
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."
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.
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 seven 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 disinfection 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.
The study conducted by Dr. Domingo has shown commercial sex workers from Cebu and Manila as among the groups with a high numbers of carriers. The lowest numbers of carriers, but also among those at risk, are medical students.
"If you are between the ages of 18 and 34, and are sexually active with more than one partner in a six-month period or if you've been diagnosed with another sexually transmitted disease, you are at a greater risk," claims Dr. Edward Beruff, the American director of vaccine products for SmithKline Beecham Pharmaceuticals in Philadelphia.
"When a person becomes infected by the HBV, the virus travels to the liver where it enters individual liver cells," said Prof. Nancy Leung, consultant and honorary associate professor at the Prince of Wales Hospital in the Chinese University of Hong Kong. "Here, it replicates and may reenter the blood stream or reinfect other liver cells."
Symptoms of initial infection with Hepatitis B result from the body's attempt to defend itself against infection.
"Those individuals with the most severe of symptoms are therefore most likely to eliminate the virus from their body while those with no symptoms or have very mild complaints -- typically children are most likely to retain the virus and become long-term carriers."
Professor Leung added that HBV may remain in some individuals after the initial infection and the patients are said to be chronic hepatitis B carriers when part of the surface of the virus remains in the blood for more than six months.
"The result of long-term carriage of the HBV is continuing inflammation of the liver, which may lead to serious liver damage and cancer," she said.
For Bisaya stories from Davao. Click here. (May 29, 2006 issue)
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