HEPATITIS B INFECTION

Innovative Biotech LtdAbujaKeffiUSA

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 companyFull HIV treatment/monitoring servicesHepatitis treatment and monitoringVaccine administration for Hepatitis B, Typhoid Fever, Meningitis, etc Vaccine productionResearch and developmentCapacity building and trainingClinical trails for vaccines and drugsGenetic testing and analysis, DNA ID card, paternity testing

High tech laboratory investigationsHIV screening tests, HIV ELISA Western Blot Blood chemistryCD4/CD3/CD8 counts (FACS count) BED AssaysViral Load (real time) and drug resistance testing.

Others Serological testing for HBsAG, HBeAG, Typhoid, Malaria, TB, HCV, etcGeneral 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 etcToxins – 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 HEPATITISVIRAL HEPATITIS

Water born infectionWater born infectionCommonest cause of HepatitisCommonest cause of HepatitisSelf limiting diseaseSelf limiting diseaseNo sequelaeNo sequelae

Virus AVirus A EE

Virus BVirus B CC DD

Parental or Blood contactParental or Blood contactSpecific prevalence in different Specific prevalence in different countriescountriesChronic disease patternChronic disease patternSequelae – Chronic Liver diseaseSequelae – Chronic Liver disease

Liver CancerLiver 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 cancerAbout 10- 20 mill. Nigerians are estimated to be carriers of the virus without knowing.

Hepatitis B virus

It is a DNA virus with complex structureVirus can be easily detected in the bloodVirus 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 virusIncubation period 2 - 5 monthsThe 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 Pre-chewing 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.

Low/NotHigh Moderate Detectable

semenserum vaginal fluidblood

wound exudates saliva

urinefecessweat

tearsbreast milk

Concentration of HBV in Various Body Fluids

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 Hepatitis-B - The DiseaseDisease

Acute HepatitisAcute HepatitisCan remain as Can remain as silent Carriersilent Carrier

Massive Liver Massive Liver disease/ Acute disease/ Acute Liver failureLiver failure

Chronic HepatitisChronic Hepatitis

Cirrhosis of Cirrhosis of LiverLiver

Liver CancerLiver Cancer

DEATHDEATH

RecoveryRecovery

• 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.

Will I ever get rid of the virus?

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 Important features of Hep-B Liver diseaseHep-B Liver disease

• Infected children carry the virus and manifest Infected children carry the virus and manifest the disease at prime agethe disease at prime age

• Infected adults often clear the virusInfected adults often clear the virus• Once chronic hepatitis - it invariably progress Once chronic hepatitis - it invariably progress

to Cirrhosis of Liver – which is the “End Stage to Cirrhosis of Liver – which is the “End Stage of Liver”of Liver”

• Hep-B is the best known - Cancer producing Hep-B is the best known - Cancer producing virus - 220 times powerful in producing the virus - 220 times powerful in producing the Liver cancerLiver cancer

Normal liver

Cirrhotic liver

Cirrhotic liver

Cirrhotic liver

Liver cancer

Liver cancer

Liver cancer

TreatmentAim is to halt the progression of liver damage by

Suppressing viral replication

Eliminating the infection

• The complicated HepatitisThe complicated Hepatitis – Chronic hepatitis – Chronic hepatitis requires expensive treatment – antiviral drugs – requires expensive treatment – antiviral drugs – Lamivudine and immune modulators – Interferons. Lamivudine and immune modulators – Interferons. Unfortunately such treatments are not with good Unfortunately such treatments are not with good success.success.

• Once Cirrhosis is established or Liver cancer starts Once Cirrhosis is established or Liver cancer starts the treatment is only Liver transplantation which is the treatment is only Liver transplantation which is the most expensive therapy and in Hep-B disease it the most expensive therapy and in Hep-B disease it is more complicated.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 Prevention of Hep-B virus by vaccination is the most by vaccination is the most

effective method in effective method in eradicating the Liver eradicating the Liver

CancerCancer

WHO 1997WHO 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

• 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 Vaccine

0

2

4

6

8

10

12

14

1967 1970 1973 1976 1979 1982 1985 1988 1991 1994 1997 2000

Year

Cas

es p

er 1

00,0

00 P

opul

atio

n

Source: NNDSS

Hepatitis B by Year, United States, 1966 - 2000

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:

080230567740803494017408060504949

Or visit us in any of our offices.1 Abdu Abubakar Street, Opp. New Keffi Hotel, Keffi, Nasarawa StateSillazeka Plaza, Plot 444, Zone B5, Utako District, Behind Peace Pack, Abuja

Your health is your wealth.