UNAIR NEWS – Hepatitis B is a contagious liver infection caused by hepatitis B virus (HBV). Infection or inflammation can cause liver damage and progress to fibrosis (scar tissue) to cirrhosis or liver cancer. To date, an estimated 240 million people are infected with chronic hepatitis B worldwide.
Hepatitis B is known as an endemic disease. Endemic disease is a disease that attacks a specific geographical area or population group. Development and health service facilities that have not been evenly distributed and are adequate cause prevention and treatment measures difficult to reach by certain communities. Therefore, many endemic diseases are found in developing countries like Indonesia. Indonesia has recorded moderate to high endemicity of HBV infections. Based on Basic Health Research (Riskesdas) in 2017, as many as 7.1 percent of Indonesia’s population is suspected of having hepatitis B.
Professor of Faculty of Medicine (FK) Universitas Airlangga (UNAIR) Prof. Maria Lucia Inge Lusida Dr., M. Kes., Ph.D., SpMK said that Indonesia has a moderate to high prevalence of hepatitis B, and endemicity varies between provinces. The high prevalence of hepatitis B in some areas is due to geographical isolation. Some community groups in remote areas in Indonesia are still experiencing difficulties in gaining access to adequate health services.
“The prevalence in each region is not the same. Hepatitis B can be chronic and lead to liver cancer, that’s what to fear. Moreover, the highest transmission is from infancy, from mother to child. It was deemed incurable, he will carry it on for life, ” she explained.
There are two ways of transmitting hepatitis B, vertically and horizontally. Vertical transmission occurs through the birth process of a mother with hepatitis B to her baby. Second, horizontal transmission through actions that allow the transfer of body fluids (blood or semen) from people infected with HBV to the body of a healthy person.
Ninety-five percent of transmission of Hepatitis B is vertical transmission, i.e. from mothers who are positive for hepatitis B to their babies (Infodatin, 2017). According to the Ministry of Health of the Republic of Indonesia, every year there are an estimated 120 thousand babies born with hepatitis B, and 95 percent of them have the potential to experience chronic hepatitis which leads to liver cancer.
The Importance of Hepatitis B Screening and Immunization
Every mother does not want her child to be born with hepatitis B. Therefore, pregnant women are recommended to do screening (early detection) of hepatitis B. Pregnant women who suffer from hepatitis B, are very susceptible to transmitting the hepatitis B virus to their babies. Because during labor, there is blood contact between mother and child. It is where hepatitis B transmission is prone. However, more than 90 percent of HBV infections during labor can be prevented if HBsAg-positive is identified in mothers.
“The prevention can be done through screening to all pregnant women. Later when giving birth, her child must immediately be vaccinated. There used to be no screening for pregnant women. Now maybe almost all have already screened for hepatitis B, “explained Prof. Inge.
“Now there is already a hepatitis B national immunization program. The national program has been implemented since 1997, meaning that it has been over 20 years, yes. So people under the age of twenty should have a low prevalence, ” she added.
If a positive pregnant woman suffers from hepatitis B, the doctor will register the baby born to get the HBIg vaccine (Hepatitis B immunoglobulin / HBIg) in less than 24 hours. Giving passive HBIg immunization will protect babies from the danger of being infected with hepatitis B. Furthermore, babies need to be given an active vaccine HB0 to stimulate antibodies, so that their bodies have immunity warding off the hepatitis B virus. Babies will also be given a vaccine combination in the form of diphtheria vaccine, pertussis, and tetanus at the age of two, three and four months.
Late immunization will increase the chance of HBV infection in infants. Thus, early prevention is very important to reduce the risk of hepatitis B infection later in life. Given that until now there is no drug that can really cure hepatitis B.
“There is some medicine, but it can only suppress the amount of the virus until it is not detected. But it does not mean it lost completely. Until now, medicine cannot reach viruses that enter the liver cell nucleus, “said Prof. Inge.
Author: Zanna Afia Deswari
Editor: Khefti Al Mawalia
Lusida, Maria Lucia Inge, et al. Current Hepatitis B Virus Infection Situation in Indonesia and Its Genetic Diversity.World Journal of Gastroenterology. 2016: 22(32)