Inflammation of, or damage to, the liver can result in a reduction of its functioning efficiency, and may lead to a number of physical health complications. One of the major factors behind liver inflammation is the hepatitis B virus.
70–75% of liver cancer cases among Thai people are caused by chronic hepatitis B infections. The virus has also been classified as one of the 10 deadliest diseases worldwide. In Thailand, there are currently over 3.5 million people suffering from chronic hepatitis B infections.
Hepatitis B infection causes an immune system reaction that damages the liver and its cells. An infection lasting for longer than 6 months is referred to as chronic liver inflammation. This condition can cause fibrosis in the liver, which may lead to liver cirrhosis and, eventually, liver cancer. Here in Thailand we have found that a large number of liver cancer cases – around 90% – have a history of viral hepatitis, meaning that it is entirely reasonable to associate hepatitis B directly with chronic liver inflammation and liver cancer.
Hepatitis B is generally transmitted through one of four channels:
Approximately 10% of infants and 30–50% of adults who get the hepatitis B virus will experience acute symptoms during the first 1–3 months. These symptoms will come and go, and other illnesses are also likely to appear at this time. The most obvious symptoms of hepatitis B infection are:
Should no other complications arise, these symptoms tend to go away by themselves. However, some patients will experience hepatitis B infections lasting more than 6 months. Although there may not be any visible symptoms, these long-duration infections are referred to as the chronic stage of the illness. Some patients may experience prolonged chronic liver inflammation that causes liver cirrhosis, which has a number of symptoms including:
Ultimately, liver failure and death are likely to occur, whether the infection is acute or chronic. Moreover, hepatitis B sufferers are at risk of spreading the disease through contact with blood or bodily secretions.
Treatment for hepatitis B involves inhibiting viral replication, thereby reducing the amount of liver inflammation. This can slow the disease’s progression and decelerate the onset of liver cirrhosis or liver cancer. Additionally, some treatments can reduce liver fibrosis.
It is crucial for hepatitis B patients to understand that not all chronic hepatitis B sufferers are suited for treatment, and that special consideration will be given to cases where the virus is spreading, liver inflammation is occurring, or for those with existing liver disorders. There are some points at which the disease is more responsive to treatment, meaning the doctor will consider treating patients who possess certain key indicators.
The doctor will be responsible for determining when antiviral medication treatment can be discontinued, using a number of key indicators to make that decision. Current treatment techniques mean that some patients may be required to take medication for the long-term, or even for the remainder of their lives. Patients should not be the ones who decide when to halt their medication. Medical staff will also monitor the situation of patients who do not yet require such treatment to enable a rapid response should any indicators become apparent, as well as to enable early detection for the onset of liver cancer.
The First Class Honors M.D.,Faculty of Medicine, Prince of Songkla University, 1985.