Download treatment of hepatitis b infection

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Innovative Biotech Ltd
Mission statement
To provide and enhance better health
and life expectancy by eradication of
diseases in Africa through innovative
production of biotech products and
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,
Western Blot
Blood chemistry
CD4/CD3/CD8 counts (FACS count)
BED Assays
Viral Load (real time) and
drug resistance testing.
Serological testing for HBsAG, HBeAG, Typhoid, Malaria, TB,
HCV, etc
General ELISAs
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.
Virus A
Virus B
Water born infection
Commonest cause of Hepatitis
Self limiting disease
No sequelae
Parental or Blood contact
Specific prevalence in different
Chronic disease pattern
Sequelae – Chronic Liver disease
Liver Cancer
Viral hepatitis B is a serious global health
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
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
wound exudates
vaginal fluid
breast milk
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
Chronic Hepatitis
Cirrhosis of
Liver Cancer
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
Aim is to halt the
progression of liver damage
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
• 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 of Hep-B virus by
vaccination is the most effective
method of preventing the Liver
Cancer. Vaccination has worked for
Small pox
Prevention of Hep-B virus
by vaccination is the most
effective method in
eradicating the Liver
WHO 1997
Why Vaccination
Vaccines provoke immune responses that
serve to curtail future infections with that
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
1967 1970 1973 1976 1979 1982 1985 1988 1991 1994 1997 2000
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
Specialized laboratory and treatment
Post-immunization test
Service delivery at your place of work
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
Contact us today:
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.