Hepatitis B cases on the rise in Kenya

Saturday June 28 2014

By CHRISTABEL LIGAMI, Special Correspondent

Researchers at the Kenya Medical Research Institute (Kemri) are sounding the alarm over the increasing number of Hepatitis B cases in Kenya.

Hepatitis B is caused by the hepatitis B virus (HBV), and is passed from person to person through bodily fluids such as blood, semen or vaginal fluids.

According to the Kemri researchers, the prevalence rate of HBV is about 10 per cent among pregnant women, and more than 30 per cent among liver disease patients attending clinics.

This, they say, could also lead to an increase in HBV infection in newborn babies as the viral disease commonly spreads from mother to child at birth, a reason pregnant mothers are being encouraged to go for routine tests to detect it.

However, the scientists say the reason for the rise in HBV in Kenya is still unknown since no scientific study has been done to explain the phenomenon.

Elijah Songok, head of Kemri’s Infectious and Parasitic Diseases Research Programme, says that over the past two years, the prevalence of HBV among blood donors has been rising, surpassing that of HIV threefold.

If untreated, HBV may lead to liver cirrhosis and other liver cancers. The modes of transmission are similar to HIV — sexual transmission, contaminated blood products and mother to child transmission.

Last year, about 1,200 blood donations out of 150,000 screened nationwide were found HIV-positive, compared with 3,000 who were HBV-positive.

“Given that blood donors are a highly selected population, researchers contend that the prevalence in the general population may be much higher,” said Prof Songok.

“This should be a cause for alarm, as similar high data is being registered among HIV infected persons, showing a rising prevalence of co-infection with HBV.”

Co-infected persons have an increased rate of liver disease, higher HBV and HIV viral loads, and poor response to antiretroviral drugs.

According to the Kemri researchers the regions with high prevalence of HBV in Kenya are around northern parts of Kenya (Pokot County, Turkana County, Garissa County and Wajir County).

“The likely causes of HBV in the region are cultural practices like tattooing, circumcising without using sterilised implements and because the regions are dry and  people may not be able to get proper nutrition that ensures strong immunity.

“The majority are not able to clear the virus when they are infected, and end up becoming chronic carriers of HBV,” said Prof Songok.

This trend is consistent with the global picture. HBV is one of the most common viral infections globally. It is estimated that two billion people worldwide have been exposed, of which 150 million are chronically infected.

However, HBV is 50-100 times more infectious than HIV and health workers who accidentally get needle stick injuries have a higher chance of infection from HBV than from HIV.

The majority of persons infected with HBV suffer acute infection and clear the virus within weeks. However, some develop a long-term chronic infection and later liver cancer. Despite the presence of a HBV vaccine, not all vulnerable populations have access.

Ahead of this year’s World Hepatitis Day on July 28, Kemri the Ministry of Health and their partners are creating awareness through sensitisation of the public on the dangers of HBV infections and are planning to provide HBV testing and vaccinations, as well as holding a two-day stakeholders forum to chart the way forward for HBV prevention, treatment and control.

Hepatitis B virus can cause an acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

A vaccine against hepatitis B has been available since 1982 and it is 95 per cent effective in preventing infection and its chronic consequences, and was the first vaccine against a major human cancer.