Viet Nam News
Dr Remy Romney
The hepatitis B virus infects about 2 billion people, or almost one third of the world’s population. Some 360 million of them have developed chronic hepatitis. Việt Nam has a high prevalence of hepatitis B: 8.6 million people are hepatitis B-positive.
What is the hepatitis B virus?
Hepatitis B, like all viruses, acts like a parasite because it needs a host cell to multiply. It is a DNA virus, interacting with human hepatic DNA cells to multiply.
How is hepatitis B transmitted?
It is sexually or mother to child transmitted during delivery (hepatitis B virus is found in blood, in mothers’ milk, menstruation blood, and sperm). It is one hundred times more infectious than HIV, and 10 times more infectious than hepatitis C. It can survive out of the human body for more than a week, on clothes or other surfaces.
How does hepatitis B infection occur?
The first stage of infection is acute hepatitis B when the infected person experiences extreme fatigue, jaundice, nausea, dizziness, arthritis and more. Some 90 per cent of patients who contract hepatitis B from unprotected sexual intercourse will have a spontaneous complete recovery. On the other hand, in the case of a vertical transmission (mother to child during delivery), 90 per cent of newly born babies will develop chronic hepatitis. In such cases, the body’s immune system cannot eliminate the virus.
What are the consequences of chronic hepatitis B?
Little by little, the virus will destroy the liver cells (hepatocytes) which will be replaced by scar tissue cells (fibrocytes). This is the remodeling process of the liver also called fibrosis. When most of the liver tissue has become fibrotic, the condition is called cirrhosis: the liver stops working normally. This results in the first complications: ascites –an accumulation of fluid in the abdominal cavity. As the liver cannot get rid of toxic byproducts, certain substances like ammonia accumulate in the brain and impair brain function (encephalopathy). Esophageal bleeding can occur from hemorrhoids forming in the esophagus as a result of increased blood pressure in the liver vessels, and ultimately the most dangerous complication -liver cancer (hepatocellular carcinoma).
Which exams will a doctor prescribe to evaluate the gravity of the infection?
Your doctor will ask questions about personal and family medical history to try to figure out the most likely path and time of the infection (whether through the mother, drug use, piercings, tattoos). The doctor will then order a blood test and an abdominal ultrasound. Sometimes for chronic hepatitis cases, before any treatment, the hepatologist (liver specialist) will have to take a tiny sample (biopsy) of the liver.
What are the principles of treatment?
The first treatment for hepatitis B is prevention. A person is screened for antibodies against the virus and if negative, should be vaccinated. The vaccine is harmless, very effective and in case of a positive immune response, which means the vaccinated person develops antibodies against the virus, provides lifelong immunity and protection. Every pregnant woman has to be screened for hepatitis B and if positive, vaccine and antibodies will be given to the newborn to minimize the risk of infection to the baby. In chronic hepatitis, complete recovery is not possible. However medical treatment and regular check-ups will help to reduce the risk of fibrosis and its consequences and also to prevent cirrhosis and hepatocellular carcinoma.
Hepatitis B screening: Are you concerned?
Have you ever received a blood (transfusion), especially before 1992?
Have you ever tried drugs (nasal or intra-venously), even a long time ago?
Did you have major surgery or major medical examinations: biopsy, endoscopy?
Did your mother have hepatitis B or C when you were born?
Did your partner or someone in your close family have hepatitis B or C?
Have you had piercing or a tattoo done?
Did you live or were you born in a country with high prevalence of hepatitis: Asia, Africa?
Dr. Remy is an internationally trained specialist in gastroenterology and hepatology who has worked in health care institutions with high prevalence of hepatitis. He recently joined the Hanoi French Hospital to bring his expertise to our customers and colleagues.
If you have any questions or concerns regarding hepatitis, prevention and treatment, please contact us at 84 – 24.3577.1100, access www.hfh.com.vn, or email us at firstname.lastname@example.org. Address: 1 Phương Mai, Đống Đa, Hà Nội