Hepatitis, cross river
The image of a human liver and intestines next to a superimposed image of the Hepatitis Virus.

Preventing Hepatitis B Essential to Curing Liver Cancer – Expert

A professor of Medicine, Gastroenterology and Liver Unit, Faculty of Clinical Sciences, College of Medicine University of Ibadan, Professor Jesse Otegbayo, says the key element to preventing liver cancer is to tackle the spread of Hepatitis B.

The physician noted that HBV has long been known as a silent killer with its ability to silently ravage the liver and increase the risk of developing liver cancer.

Speaking at his inaugural lecture at the University of Ibadan, titled, ‘The Human Workhorse and Microbial Afflictions: Hepatitis Its Fatal Sting and The Tragic Trajectory’, Otegbayo explained that a study carried out among unremunerated blood donors at the university, discovered that the most common risk factor for the spread of HBV is scarification, followed by indiscriminate injections.

The World Health Organisation (WHO) recently released a report revealing that the viral hepatitis has become the second leading infectious cause of death, killing 3,500 people a day and contributing to more than a million deaths a year.

According to the WHO 2024 Global Hepatitis Report, the number of lives lost due to viral hepatitis is increasing, with 1.3 million deaths per year, the same as tuberculosis, a top infectious killer.

The report, released at the World Hepatitis Summit, noted that despite better tools for diagnosis and treatment, and decreasing product prices, testing and treatment coverage rates have stalled.

It, however, stressed that reaching the WHO elimination goal by 2030 should still be achievable if swift actions are taken now.

Reacting, the professor of Medicine emphasised the importance of raising awareness about the dangers of HBV and how the virus can be prevented.

To stem the rising cases of liver cancers, the expert said that the identification and prevention of factors that encourage the spread of HBV will break the link between the virus and liver cancer.

He listed various ways of transmission, such as sexual contact, receiving unscreened blood or blood products, dental procedures, surgeries with unsterilized equipment and sharp objects, and participating in contact sports, among others.

Acknowledging that the HBV vaccine has been developed and declared safe and effective, even in pregnancy, Otegbayo said several countries, including Nigeria, are signatories to the inclusion of the HBV vaccine in the National Programme on Immunisation but that the degree of implementation and compliance have been low.

According to him, in Nigeria, only 41 per cent of newborns are immunised against HBV, according to the 2022 World Bank data.

Otegbayo while noting that a study of healthcare workers’ hepatitis vaccination for HBV at the UCH, Ibadan, showed 59.7 per cent completed the three doses of the vaccine, said healthcare workers are among the greatest risks for HBV infection and are supposed to be most knowledgeable.

“The vaccination rate among non-healthcare workers is then better imagined. I must however praise the efforts of the Students Union government of the University of Ibadan for the concerted efforts and measures it has put in place in the last few years to ensure that students are screened and immunised against HBV,” he stressed.

He argued that there is ample evidence of tested and workable approaches and experiences that showed that if appropriate measures are taken, the problems of HBV and liver cancer would be surmountable.

The don added, “In the Gambia, the smallest West African Country with a population of less than one and a half million human heads, and Taiwan, longitudinal studies with The institution of HBV immunisation have reduced the incidence of HBV infection as well as liver cancer.”

He said the prevention and treatment of liver cirrhosis by treatment or monitoring of individuals who are HBV positive and treatment of patients with chronic hepatitis to prevent progression to liver cirrhosis and subsequent development of liver cancer, cannot be overemphasised.

“Again, in Sub-Sahara Africa, hepatitis B virus is the most common cause of liver cirrhosis. There are genetic causes of HCC, and there is a need to explore the causes of death by autopsy, as studies have shown that liver cancer is more common among individuals with a family history of liver cancer, both in those with environmental risk factors like HBV and HCV and those without known environmental risk factors.

“Unfortunately, one of our studies has shown a drastic decline in autopsy rates in Ibadan,” Otegbayo stated.

He expressed worry about the size of Nigeria’s population and what it portends if no concrete actions are taken urgently, adding, “The World Bank Data, 2022, showed a high fertility rate in Nigeria, with an average of 5.2 births per woman, 102 births per 1000 of women aged between 15 and 19 years, and a population growth rate of 2.4 per cent, which is above the world average.

“Comparing the birth rate per woman in other African countries, Egypt (2.9), Ethiopia (4.2), Ghana (3.6), Senegal (4.4), and Sierra Leone (4), it is worthy of note that developed countries have less than 2 births per woman.

“Population explosion is imminent in Nigeria, and it will, needless to say, overwhelm and overstretch our healthcare system, thereby worsening our health indices.

“It is estimated that by 2050, Nigeria will have a population of 401 million people, larger than the United States of America. This is a ticking time bomb.”

“The managers of our healthcare system deserve a certain level of financial and training empowerment to be able to function optimally. Healthcare costs are expensive anywhere in the world.

“The Federal Government has also come out with a workable family planning blueprint, which is aimed at curbing the country’s population explosion. Nigeria, therefore has to address our primary healthcare system, institute universal healthcare and put in measures to control our population.”