Despite one in 20 South Africans being infected with the hepatitis B virus – which causes about 820 000 deaths a year globally and is one of the leading causes of liver cancer – few people know about or have been tested for the virus, according to experts, who are calling for increased awareness and access to testing, and implementation of vaccines at birth.
Writing in GroundUp, Daniel Steyn reports that at a media briefing last week organised by the Gastroenterology and Hepatology Association of Sub-Saharan Africa (GHASSA), a panel of experts stressed the need for urgent interventions to eliminate hepatitis.
Apart from the need for heightened awareness, they said it was imperative to prevent childhood transmission through birth-dose vaccination and the screening and treating of pregnant women.
In South Africa, about 2.8m people have chronic hepatitis B, with liver cancer resulting from this escalating not just in Africa but worldwide.
Hepatitis B is transmitted through bodily fluids, including semen and blood. Antiretroviral treatment for chronic hepatitis B is available, but only 22% of cases are diagnosed. An estimated 76 000 children in South Africa under five are infected, and thus more likely to develop a chronic infection.
In children, a drop of blood shared through play can transfer the virus.
“They walk around like ticking timebombs, spreading infections,” said Dr Neliswa Gogela, liver disease specialist at Groote Schuur. Hepatitis B is 100 times more infectious than HIV, added Gogela.
Children born in this country receive a hepatitis B vaccine at six, 10, and 14-weeks-old.
However, if a vaccine dose were given at birth, it would cut out the first six weeks during which a child could become infected.
Birth-dose vaccines are government policy but it has not yet been implemented here, although other African countries like Namibia have introduced these.
Because the virus can also be transmitted from mother to child during and after birth, pregnant women should be screened as part of prenatal and antenatal healthcare services, said Professor Wendy Spearman, head of Hepatology at UCT. Those eligible for treatment should receive antiretrovirals to prevent transmission of the virus to the child.
Screening and testing for hepatitis are not easily accessible. Anyone wanting an HIV test can go to any government clinic and receive a point-of-care rapid test, but cannot do the same for hepatitis B.
Rapid tests B are available but have not been rolled out by the government, so the only way to do a test through public health facilities is to take blood, which is sent to a lab for testing.
While HIV, malaria and TB have attracted significant attention and funding, hepatitis has not. “We need people living with hepatitis B to demand access to treatment,” added Spearman.
GroundUp article – This vaccine at birth can save thousands of lives (Creative Commons Licence)
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