By Purity Thuku
The Kenya Medical Association (KMA) is sounding the alarm over increased cases of hepatitis B virus (HBV) in Kenya.
According to the World Health Organization (WHO), new findings show an estimated 350-400 million individuals are infected with hepatitis B virus (CHBI) globally. Current estimates put the prevalence of hepatitis B virus (HBV) at 8 percent in the country.
Hepatitis B is caused by HBV and is passed from one individual to another through bodily fluids, including semen, vaginal fluids, and blood. Specimens are tested for total HBcAb (hepatitis B core antibody), which is the market for HBV infection. The samples are then tested for Hepatitis B surface antigen (HBsAg). If both specimens test positive, the individual is at the chronic stage.
The estimated prevalence of CHBI IN Kenya is 2.1 percent, corresponding to about 400,000 cases. This, KMA says, could see an increase in HBV infections spread from mother to child at birth. The organization says the prevalence is currently about 10 percent among pregnant women and over 30 percent among liver disease patients.
Dr. Charles M. Ngari, a clinical pathologist and a member of the Kenya Medical Association, said the antigen drops almost immediately in children exposed to the virus during birth. Women are in this regard encouraged to attend routine tests for early detection.
“90 percent of children who develop HBV in the acute phase advance to the chronic stage with a 40 percent chance of developing liver cancer and cirrhosis. HBV and CHBI must be treated as a major public health concern,” Ngari noted.
Studies suggest that Hepatitis B infections that occur in early childhood through iatrogenic exposure and horizontal transmission account for the highest HBV infections in Africa.
Ngari observed that focusing on the baseline of the prevalence in the country would be critical for public health policy decision making.
Alice R. Ngigi, a pharmaceutical Business Development Associate collaborating with GILEAD Sciences notes that 91 percent of people living with HBV globally are not diagnosed, with at least 2 million Kenyans estimated to be living with the virus. The Gilead representative also noted that at least 70 million Africans are affected by chronic viral hepatitis.
“The global hepatitis epidemic is 10 times larger than the global human immunodeficiency virus – HIV epidemic. Current figures are worrying, and Kenyans need to feel the urge of early screening. We have done the research at Gilead, and the health industry needs to treat these findings with urgency. The trajectory of this virus is liver disease,” Alice said.
She also noted that liver cancer triggered by either Hepatitis A, B, or C, can be 100 percent preventable by vaccination. Left untreated, HBV could increase the rate of higher HBV, HIV viral loads, liver disease, hepatocellular carcinoma, and poor response to antiretroviral drugs.
A different recent study performed a systematic review, and the data estimated that the prevalence of CHBV in Africa is 8.8 percent. In majority of low and middle-income countries where there is limited surveillance of HBV, the estimates are based on data pooled by sources.
A recent HBV prevalence study conducted in Uganda, for example, found that the prevalence was at 10 percent. In Kenya, there has been a clear disparity in HBV by geographic area.
In one study, the prevalence of hepatitis B surface antigen (HBsAg) was at 112 percent in North Eastern Kenya, and 8.8 percent in Turkana. The risk factor is not evident due to the difficulty in establishing when the exposure and the infection occurred in time.
Hepatitis is 100 times more infectious than HIV. Health workers who get needle stick injuries accidentally have higher chances of acquiring HBV infection than HIV.
Researchers now contend that the epidemic may be much higher, and is therefore crucial that HIV infected persons seek for HBV testing and treatment. The World Health Organization recommends immediate initiation into anti-retroviral therapy irrespective of the patient’s CD4 count.