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HEPATITIS B INFECTION Innovative Biotech Ltd Abuja Keffi USA Mission statement To provide and enhance better health and life expectancy by eradication of diseases in Africa through innovative production of biotech products and services. IBL Infrastructures Multipurpose Biotechnology company Full HIV treatment/monitoring services Hepatitis treatment and monitoring Vaccine administration for Hepatitis B, Typhoid Fever, Meningitis, etc Vaccine production Research and development Capacity building and training Clinical trails for vaccines and drugs Genetic testing and analysis, DNA ID card, paternity testing High tech laboratory investigations HIV screening tests, HIV ELISA Western Blot Blood chemistry CD4/CD3/CD8 counts (FACS count) BED Assays Viral Load (real time) and drug resistance testing. Others Serological testing for HBsAG, HBeAG, Typhoid, Malaria, TB, HCV, etc General ELISAs HEPATITIS Hepatitis means inflammation of the liver, characterized by diffuse necrosis (death) of the liver cells. The causes are many Viruses (Hepatitis virus A-G, CMV, EBV, enteroviruses, adenoviruses, etc) Non viral infections (Toxoplasmosis, systemic fungal infection, leptospirosis, etc) Drugs (cpz, indocid, aldomet, pcm, halothane) Chemicals-alcohol,iron, copper sulphate etc Toxins – aflatoxins, mushrooms etc Functions of the Liver The liver helps in the regulation and synthesis and secretion of many important substances storage of nutrients purification, and clearance of waste products, drugs and toxins from the body. VIRAL HEPATITIS Virus A E Virus B C D Water born infection Commonest cause of Hepatitis Self limiting disease No sequelae Parental or Blood contact Specific prevalence in different countries Chronic disease pattern Sequelae – Chronic Liver disease Liver Cancer HEPATITIS B Viral hepatitis B is a serious global health problem. World-wide there is an estimated 450 million persistent carriers of hepatitis B, 50 million of which are in Africa. About 10% of these carriers will develop chronic hepatic illnesses, such as liver cirrhosis or liver cancer About 10- 20 mill. Nigerians are estimated to be carriers of the virus without knowing. Hepatitis B virus It is a DNA virus with complex structure Virus can be easily detected in the blood Virus particles, as well as excess viral surface protein, are shed in large amounts into the blood The virus is 30 TIMES more infective than HIV virus Incubation period 2 - 5 months The virus replicates in the liver Viraemia is prolonged Hepatitis B Transmission 1) Blood: Blood transfusions, serum products, sharing of needles, razors, Tattooing, acupuncture, Renal dialysis & Organ donation 2) Sexual intercourse 3) Horizontal transmission in children, families, close personal contact (major mode of transmission in South Africa where the majority of individuals become infected at between three and nine years of age). Horizontal transmission also occurs in children's institutions and mental homes. Transmission of HBV (2) Percutaneous transmission – sharing of injection drug use equipment, needle stick injury, ear-piercing, body piercing, tattooing, inadequate sterilization of medical equipment, scarification Household and interhousehold transmission – less risk but significant - can occur in settings such as shared toothbrushes, razors, combs, washcloths Passed from child to child by biting, shared objects, oozing cuts, impetigo, etc or by Prechewing food for babies and children Transmission contd. 4. Vertical transmission – peri natal transmission from a carrier mother to her baby; transplacental (rare), during delivery, post natal (breast feeding/close contact) Not spread by sneezing or coughing, sharing eating utensils. Concentration of HBV in Various Body Fluids High blood serum wound exudates Moderate semen vaginal fluid saliva Low/Not Detectable urine feces sweat tears breast milk Symptoms Majority of Viral hepatitis infections are with out symptoms. Common clinical features however include: low fever, headache, muscle aches, tiredness, loss of appetite ,diarrhea, stomach pain, anorexia, nausea, jaundice, vomiting, right upper quadrant, raised liver enzymes AST and ALT. Jaundice is the hall mark of infection, but tends to develop late. Jaundice in Acute Viral Hepatitis Hepatitis-B - The Disease Can remain as silent Carrier Acute Hepatitis Massive Liver disease/ Acute Liver failure Recovery Chronic Hepatitis Cirrhosis of Liver Liver Cancer DEATH Will I ever get rid of the virus? • The hepatitis B virus takes about 2 months to show up in your blood. It may stay in your blood for months or years. Acute Hepatitis B. • 9 out of every 10 adults will get rid of the virus from their bodies after a few months. We say they have acute hepatitis B. Chronic Hepatitis B. • 1 out of every 10 adults will never get rid of the virus from their bodies. We say they have chronic hepatitis B. They are called carriers. Chronic HB infection 85% - 90% of infants infected at birth 20% - 50% of children <5 yrs 2% - 6% of older children and adults Important features of Hep-B Liver disease • Infected children carry the virus and manifest the disease at prime age • Infected adults often clear the virus • Once chronic hepatitis - it invariably progress to Cirrhosis of Liver – which is the “End Stage of Liver” • Hep-B is the best known - Cancer producing virus - 220 times powerful in producing the Liver cancer Normal liver Cirrhotic liver Cirrhotic liver Cirrhotic liver Liver cancer Liver cancer Liver cancer Treatment Aim is to halt the progression of liver damage by Suppressing viral replication Eliminating the infection • The complicated Hepatitis – Chronic hepatitis requires expensive treatment – antiviral drugs – Lamivudine and immune modulators – Interferons. Unfortunately such treatments are not with good success. • Once Cirrhosis is established or Liver cancer starts the treatment is only Liver transplantation which is the most expensive therapy and in Hep-B disease it is more complicated. Prevention Prevention of Hep-B virus by vaccination is the most effective method of preventing the Liver Cancer. Vaccination has worked for Small pox Polio Measles Prevention of Hep-B virus by vaccination is the most effective method in eradicating the Liver Cancer WHO 1997 Why Vaccination Vaccines provoke immune responses that serve to curtail future infections with that organism. Vaccination is a natural way to stimulate our immune system to fight a disease. Through vaccination our immune system recognises the pathogens and develops a suitable response prior to being faced with the "real disease Hepatitis B Vaccine • Licensed in 1982; the genetically engineered form is in used. • 3 dose series, typical schedule is 0, 1 and 6 months • no maximum time between doses Hepatitis B by Year, United States, 1966 - 2000 Cases per 100,000 Population 14 12 10 8 6 4 2 0 1967 1970 1973 1976 1979 1982 1985 1988 1991 1994 1997 2000 Year Source: NNDSS Declining trend due to mass vaccination. Vaccination contd. Compulsory vaccination has eradicated or greatly reduced the impact of some of the world's most devastating diseases, such as small pox, polio, measles With better vaccines, and more comprehensive and effective vaccination programmes, even more suffering and deaths could be prevented Vaccination process • Conduct a HBsAg test • If negative, receive the vaccine • The vaccine is to be taken, 3 times at 0, 1 and at 6 months • Protection is life long. Unique specialized service Pre-immunization screening test Vaccinology is our specialty Our CEO is a world-renowned vaccinologist Specialized laboratory and treatment services Post-immunization test Service delivery at your place of work Cost 1st course= test+1st dose= N2,000 2nd course, next month= N1,500 3rd course, 6 months= N1,500 Total package=N5,000 Discount for bulk payment=N4,500 Typhoid vaccine Vi polysaccharide vaccine Protects for 3 years Single dose injection N1,500 Contact us today: 08023056774 08034940174 08060504949 Or visit us in any of our offices. 1 Abdu Abubakar Street, Opp. New Keffi Hotel, Keffi, Nasarawa State Sillazeka Plaza, Plot 444, Zone B5, Utako District, Behind Peace Pack, Abuja Your health is your wealth.