Believe it or not… nearly 1 in 3 people worldwide have been infected with the hepatitis B virus, and about 400 million people have developed chronic hepatitis B infection. According to data from 2009, the prevalence of chronic hepatitis B infection in Thailand was as high as 8% of the population, or about 3 million people. Most individuals infected with hepatitis B virus show no symptoms. By the time they seek medical examination and treatment, the disease has progressed beyond the stage where it can be cured. This means… cirrhosis and advanced liver cancer have already developed.
We humans! The carriers transmitting the “Hepatitis B Virus”
The hepatitis B virus can be found in all bodily secretions of infected individuals, especially in the bloodstream. Therefore, it can be transmitted from one person to another. The most common routes of transmission are sexual contact and mother-to-child transmission. Once the hepatitis B virus enters the body, it goes into the bloodstream and invades liver cells. Some may experience symptoms similar to the flu, nausea, vomiting, enlarged liver, and jaundice, but most often there are no clear symptoms. The body’s immune system will try to eliminate the virus. If it cannot completely clear the virus, “chronic hepatitis B infection” will develop.
Infection… must be treated promptly because it can cause “cirrhosis” and “liver cancer”
“What should hepatitis B carriers do?” and “Do people infected with hepatitis B need treatment?” are common questions. Many think that if there are no symptoms, nothing needs to be done. However, in reality, studies following chronic hepatitis B patients for 5 years found that about 8-20% developed cirrhosis, showing symptoms such as swelling of the body and legs, jaundice, lethargy, and confusion. These conditions are beyond recovery and require liver transplantation to survive or may result in death from liver failure. Some may be diagnosed with large liver tumors, which is… liver cancer.
Treatment approach… may depend on individual factors
The hepatitis B virus is a living organism that depends on the human body to survive and can multiply within the body. Monitoring the virus’s behavior, including viral load, replication speed, and degree of liver damage, is essential for determining the appropriate treatment for each patient. For example, if a patient has a highly active hepatitis B virus that replicates quickly, with a high viral load and significant liver inflammation, this patient has a higher risk of cirrhosis and liver cancer and therefore needs treatment to reduce the viral load. Conversely, if a patient has a low viral load and no liver inflammation, the risk of cirrhosis or liver cancer is lower, and treatment may not be started immediately but requires regular monitoring and readiness to begin treatment if the virus’s behavior changes. In this regard, the treating physician’s role is to explain and educate the patient about hepatitis B virus infection.
Behavioral changes… can help treat “liver disease”!
Besides monitoring treatment, self-care is also important. Regular exercise, choosing nutritious foods, receiving hepatitis A vaccination, and avoiding risky behaviors that damage the liver such as alcohol consumption, eating moldy peanuts (which may contain fungi harmful to the liver), and taking certain medications all help strengthen the liver and reduce the risk of liver disease progression. Additionally, it is crucial for infected individuals to be careful not to transmit the virus to others.
Chronic hepatitis B infection is like a silent threat, gradually causing serious disease without symptoms in the infected person. Therefore, it is necessary to receive guidance on self-care, disease monitoring, and appropriate treatment by specialists to prolong the life of the liver as long as possible.
Dr. Choti Luangchosiri
Gastroenterology Specialist
Gastrointestinal and Liver Center, Phyathai 2 Hospital
