Hepatitis: The silent killer disease

Sep 30, 2007

TODAY is World Hepatitis Awareness Day. For many, it will pass like another ordinary day. But not for Michael, 27, who survived the killer virus. “For me, it’s my thanksgiving day because God postponed my time of death. I had full blown Hepatitis B, but I recovered,” he says happily.

By Irene Nabusoba

TODAY is World Hepatitis Awareness Day. For many, it will pass like another ordinary day. But not for Michael, 27, who survived the killer virus. “For me, it’s my thanksgiving day because God postponed my time of death. I had full blown Hepatitis B, but I recovered,” he says happily.

After several bouts of sickness which seemed like malaria did not respond to treatment, Michael was asked to take a hepatitis test after his eyes turned yellow.

“I would get headaches, fever, sweat a lot at night, vomit and eventually, I could not move. The doctors concluded it was malaria. Then I got bed-ridden with abdominal pain. Blood tests showed I was suffering from Hepatitis B. That was in February last year,” he says.

The good news was the condition was discovered, but the cost of treatment was a nightmare. After being taken through the various options, he chose the injection because it would allow him to stay on his job, as well as continue with school.

But it cost sh550,000 per injection per week for 48 weeks. Even his medical scheme could not cover the cost, until his company had to come in and top up.
Yet the treatment also presented its own side effects; fatigue, headaches and temporary memory loss. However, follow-up tests showed the virus had cleared.

Unfortunately, his sister did not survive. “She died in November, shortly after I had just recovered and the postmortem showed it was Hepatitis B,” he says.
Hepatitis is a common virus that attacks the liver and presents in five forms, A,B,C,D, and E.

Dr Ponsiano Ocama, a hepatologist (specialist in liver diseases) says A and E are transmitted like cholera (in faecal waste) and do not cause permanent damage to the liver.

“They can cause acute liver injury, but do not cause chronic liver disease like B,C and D. For some unknown reason, D cannot present where there is no B. That is why we normally concentrate on B and C — they are the most common liver infections and the leading causes of severe liver disease like cirrhosis and cancer,” Ocama says. “As we celebrate the World Hepatitis Awareness Day, the message is in our theme: Get tested and vaccinated.”

Ocama, a member of the Uganda Gastroenterology Society, says vaccination is the only effective preventive measure.

He adds that prevalence of hepatitis in Uganda stands at 8%, with the highest being in the north (about 10%).
“This is very high, given that overall prevalence in Africa is 5%. Yet B alone is between 12-15%, meaning that for every 10 people, there is at least one infected person,” he says.

Ocama adds that vaccination is in three doses, taken over a period of three months, with each doze costing sh20,000 bringing the total schedule to sh60,000.

“Many may consider this expensive, but it is not comparable to the cost of treating hepatitis. Unfortunately, there is no vaccine for C,” says Dr Kenneth Opio, also a hepatologist.

Opio says most people can only afford life-long treatment which costs about sh20,000 a month (but it is commonly provided free of charge when one is on Antiretroviral treatment).

The Ministry Of Health introduced a hepatitis B vaccination in its babies’ immunisation programme five years ago. It is given at six weeks.

“We need to change this. This vaccine needs to be given immediately after birth and a booster at six weeks, the latter being ideal for negative mothers. We emphasise that every pregnant mother tests for hepatitis B for preventive purposes for the baby at birth, but unfortunately this does not normally happen,” Opio says.

Reports show that only 40% of mothers attend antenatal care and deliver from health facilities. Yet Hepatitis B and C seem more deadly in people born with it, compared to those who acquire it later in life.

“It may stay in the liver, showing no signs, yet destroying it. But at whatever age, it will turn chronic and survival is difficult given the costs, difficulty in diagnosis and the speed at which it kills,” says Opio.

The liver swells or shrinks, preventing it from functioning properly. That is when cases of vomiting blood, swollen abdomen or kidney failure reportedly happen.

Screening and testing can be done at:

The Uganda Gastroenterology Society at Mulago Hospital Complex,
5th Floor, Medical Diagnostic Suite 8
Helpline: 0773202360

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