The term "hepatitis” is used to describe a common form of liver injury. Hepatitis simply means "inflammation of the liver”. Hepatitis B is a specific type of hepatitis that is caused by a virus, called hepatitis B virus.

It is estimated that there are more than 300 million carriers of the hepatitis B virus in the world, with over 500,000 dying annually from hepatitis B-related liver disease.

Fortunately, several medications are available for the management of chronic hepatitis B, and hepatitis B infection can be prevented by vaccination, and other daily lifestyle measures. Hepatitis B vaccines are safe and highly effective in preventing hepatitis B infection and are now given routinely to newborns and children. Currently, anyone who tests negative for hepatitis B virus and not yet vaccinated is recommended to get fully vaccinated against Hepatitis B virus infection.

There are several ways to become infected with hepatitis B virus, all of which involve mixing of bodily fluids from infected individual. Using contaminated needles can spread the hepatitis B virus. This includes tattooing, acupuncture, and ear piercing (if these procedures are performed with contaminated instruments). Sharing needles or syringes, toothbrushes, razors can also spread the virus.

Sexual contact with someone who is infected is one of the most common ways to become infected with hepatitis B. If one is infected with hepatitis B, making sure your spouse or sex partner gets vaccinated or using protection with condom.

Hepatitis B can be passed from a mother to her baby during or shortly after delivery. Having a Cesarean delivery (also called a C-section) does not prevent the virus from spreading. Evidence shows that breastfeeding is safe.

If a pregnant mother has Hepatitis B infection, the mother may be treated for hepatitis B throughout pregnancy depending on her doctor’s assessment. The baby gets a special shot right away after birth. This shot helps protect the baby from infection. The baby will then get a vaccine shot at 1 or 2 months old, and another one at 6 months. A test between 9 and 18 months will show if the baby has the infection. If not, he or she will get another vaccine shot then. It is therefore very important that routine checkup for this condition is done before and during pregnancy so that proper medical care is provided to prevent passing on the infection to the baby.

After a person is first infected with hepatitis B, they are said to have acute hepatitis. Most people with acute hepatitis B recover fully without treatment by the body’s immune system fighting it off.

However, in about 5 percent of adults (1 in 20) the virus makes itself at home in the liver, where it continues to make copies of itself for many years. People who continue to harbor the virus are referred to as "carriers”. If liver damage develops because of longstanding infection, the person is said to have chronic hepatitis. Chronic hepatitis B develops more commonly in people who are infected with the virus at an early age (often at birth)

When people first get hepatitis B, they can feel like they have the flu, and some people’s eyes or skin turn yellow (called jaundice). These symptoms usually get better, but it can take weeks to months.

Most people with chronic hepatitis B have no symptoms. But, over time, the infection can lead to a liver condition called cirrhosis. Symptoms of cirrhosis include; swelling in the belly and legs, and fluid buildup in the lungs, bruising or bleeding easily, trouble breathing, feeling full, confusion that can come on suddenly and even Coma.

Chronic hepatitis B also increases the risk of getting liver cancer.

The diagnosis of hepatitis B infection can be made by doing routine blood tests to look out for the hepatitis B virus in blood and any degree of liver damage.

For people who have chronic hepatitis B, treatments might include; medicines that fight the virus hence preventing further damage to the liver from the virus, and in severe cases one might need a liver transplant. The patient will need routine follow up by a physician to look out for any features of increasing liver damage or the levels of the virus in the blood.

After diagnosis of chronic hepatitis B infection, prevention of HIV infection (HIV worsens the outcome of hepatitis B infection), avoiding alcohol, getting vaccinated for hepatitis A and other diseases including the flu and pneumonia and asking your doctor before taking any over-the-counter pain medicines will prevent further insults to liver.

Many people with hepatitis B are able to live normal lives. It is still safe to hug and kiss, share utensils, sneeze and cough around other people, breastfeed, and many other daily activities.

Dr. Shyaka is a General Practitioner at Rwanda Military Hospital. email: iangashugi@gmail.com