Hepatitis B in Lagos?
8–11% of Nigerians Are Carriers: Most Don't Know.

Hepatitis B in Nigeria: The Silent Epidemic

Hepatitis B virus (HBV) is a blood-borne and sexually transmitted virus that infects the liver. In Nigeria, transmission primarily occurs perinatally (mother to child at birth) and in early childhood through close household contact. This means most Nigerians with hepatitis B were infected as children and have no memory of the exposure.

The danger of chronic HBV infection lies in its silence. Most people with chronic hepatitis B have no symptoms until they develop cirrhosis (liver scarring) or hepatocellular carcinoma (liver cancer), which may be 20–40 years after the original infection. Nigeria has extremely high rates of liver cancer, largely attributable to undetected chronic hepatitis B.

The tests that matter

HBsAg (surface antigen): The primary screening test, positive means currently infected. Anti-HBs: Antibody from vaccination or cleared infection, positive means protected. HBeAg and anti-HBe: Markers of viral replication level and infectivity. HBV DNA viral load: Quantifies how much virus is present, guides treatment decisions. Liver function tests and abdominal scan: Assess degree of liver damage.

Who needs treatment?

Not all HBV carriers need antiviral treatment. Treatment is indicated for patients with active viral replication (high HBV DNA), abnormal liver function tests, or evidence of liver inflammation on biopsy or scan. Tenofovir and entecavir are the preferred antivirals, effective, well-tolerated, and suppressive rather than curative.