Hepatitis B Virus Infection: Why Should You Pay Attention?

Hepatitis B virus (HBV) infection is a significant global health concern, with approximately one-third of the world's population, or 2 billion people, having a history of infection. Currently, over 350 million individuals are chronically infected with HBV. 

Understanding the reasons behind the difference between the number of people with a history of infection and those with chronic infection is essential. When the body is infected with acute HBV, a natural response mechanism is triggered to eliminate the virus. 

The ability to clear the virus naturally depends on the age of infection, with younger infections having a lower likelihood of elimination and a higher risk of becoming chronic. In contrast, infection in adulthood is associated with a higher natural clearance rate and a lower likelihood of chronic infection.

Prevalence and Transmission:

The prevalence of chronic HBV infection varies geographically, with epidemic areas including Southeast Asia, China, certain central Asian countries, Arab countries, central and southern Africa, northern South America, Alaska, and northern Canada. In these regions, the rate of individuals chronically infected with the virus exceeds 8% of the population. 

Notably, Southeast Asia and China alone account for more than 50% of individuals with chronic HBV infection due to their large population densities. HBV can be transmitted through various routes, including mother-to-child transmission, blood transfusion, unsafe sex, and needle sharing. 

The transmission routes differ across regions, with mother-to-child transmission or childhood infection being predominant in high infection rate areas, while unsafe sex, needle sharing, and blood transfusion are major transmission routes in areas with lower infection rates. High-risk groups for HBV infection include drug addicts, sex workers, and healthcare workers.

Impact and Complications:

HBV is responsible for chronic hepatitis, cirrhosis, and liver cancer. Each year, HBV-related illnesses cause approximately 1 million deaths globally. Individuals infected with HBV are 200 times more likely to develop liver cancer compared to those without the virus. 

Liver cancer accounts for about 80% of the approximately 600,000 new cases detected annually worldwide, making it a major health concern associated with HBV infection.

Challenges in Detection and Diagnosis:

Many cases of HBV infection occur through mother-to-child transmission or early childhood infection. Consequently, individuals may remain in the immune tolerant phase without clinical manifestations until reaching adulthood. 

At this stage, some people may exhibit signs of liver disease, while others may experience fatigue, poor appetite, or flu-like symptoms that are often overlooked or even asymptomatic. As a result, patients may only seek medical attention when the disease has progressed to cirrhosis or liver cancer, hindering effective interventions and treatments.

Prevention and Management:

Vaccination is a crucial strategy for reducing the rate of HBV infection. The World Health Organization recommends implementing comprehensive vaccination programs for newborns in countries with high infection rates. Additionally, all high-risk groups should be tested for HBV and vaccinated if not already infected.

Not all individuals with chronic HBV infection will develop complications. Only approximately 15-40% of chronically infected individuals will experience hepatitis symptoms and other complications. 

Therefore, it is important to have individuals with chronic HBV infection evaluated and diagnosed by specialists in Gastroenterology, Hepatobiliary Medicine, and Hepatitis. This helps avoid unnecessary treatments, which can lead to economic waste, exacerbate viral resistance mutations, and cause adverse drug effects. 

Current treatment goals focus on inhibiting HBV replication to limit disease progression, reduce cirrhosis and liver cancer rates, and decrease mortality associated with HBV-related conditions. It is crucial for individuals with chronic HBV infection to undergo regular health check-ups to assess liver disease, monitor HBV status, and analyze associated risk factors, such as co-infections with hepatitis C virus (HCV), hepatitis D virus (HDV), human immunodeficiency virus (HIV), or engaging in adverse lifestyle habits.

Pregnant women with chronic HBV infection require close monitoring and appropriate treatment to minimize the risk of transmission to their babies. It is essential to follow the instructions of healthcare professionals to ensure the best outcomes.

Conclusion:

Hepatitis B virus infection is a significant global health issue, affecting a substantial portion of the population. The consequences of HBV infection can be severe, leading to chronic liver diseases, including cirrhosis and liver cancer. 

Prevention efforts, such as widespread vaccination programs and targeted testing of high-risk groups, play a crucial role in reducing the incidence of HBV infection. Timely diagnosis and appropriate management are essential for individuals with chronic HBV infection to prevent disease progression and associated complications. Regular health check-ups, adherence to treatment plans, and close monitoring during pregnancy are vital for managing HBV infection effectively.

It is crucial for individuals and healthcare systems to prioritize the prevention, detection, and management of HBV infection. By raising awareness, implementing preventive measures, and ensuring access to quality care, we can make significant progress in combating the global burden of hepatitis B virus infection. 

Together, we can work towards a world where the impact of HBV infection is minimized, and individuals can lead healthier lives.