Chronic Hepatitis B is a long-term infection of the liver caused by the hepatitis B virus (HBV). It happens when the virus stays in the body for more than six months. While some people may have no symptoms, others slowly develop liver damage over time, which can lead to serious conditions such as liver cirrhosis (scarring) or liver cancer.
In Uganda, chronic hepatitis B is common and often goes unnoticed until the liver is already affected. Regular testing and lifelong follow-up are very important to prevent complications and protect others from infection.
With Hope Plus, you can speak with a licensed healthcare provider in minutes for guidance about hepatitis B testing, treatment options, or vaccination. Hope Plus connects you to trusted medical professionals who can help you interpret your results and create a safe, personalised care plan wherever you are in Uganda.
Key Takeaways
- Chronic hepatitis B means the virus stays in your body for more than six months.
- Many people have no symptoms but can still pass the infection to others.
- If untreated, it can cause liver scarring (cirrhosis) or liver cancer.
- Treatment often involves antiviral medicines that must be taken for life.
- Regular check-ups and blood tests help monitor liver health and treatment response.
Symptoms of Chronic Hepatitis B
Chronic hepatitis B can be symptomatic or asymptomatic, meaning some people feel sick while others do not notice anything. Common symptoms include:
- Weakness and tiredness
- Low-grade fever
- Nausea, vomiting, or loss of appetite
- Pain or tenderness on the right side of the upper abdomen
- Yellowing of the skin or eyes (jaundice)
- Dark urine and itchy skin (pruritus)
- Enlarged liver
If not properly managed, the disease may lead to complications such as liver cirrhosis or hepatocellular carcinoma (liver cancer).
Tests and Diagnosis
To confirm chronic hepatitis B, healthcare providers usually perform several tests:
- Hepatitis B surface antigen (HBsAg): stays positive for more than six months.
- Hepatitis B core antibody (Anti-HBc): helps differentiate between acute and chronic infection.
- Liver function tests (LFTs): repeated every six months to monitor liver health.
- HBeAg and HBV DNA: measure how active the virus is (if available).
- HIV testing: because having both infections can worsen the disease.
- APRI (AST to Platelets Ratio Index): used to check the level of liver scarring.
- Alpha-fetoprotein (AFP): done every six months to detect liver cancer early.
- Abdominal ultrasound: performed every 4–6 months to monitor the liver’s condition.
Treatment and Management
General Principles
- Everyone diagnosed with hepatitis B should be screened for HIV. If HIV-positive, they are referred to an HIV clinic for treatment, as some HIV medicines also treat hepatitis B.
- If HIV-negative, the patient is referred to a regional hospital for specialist care.
- Antiviral treatment helps prevent liver damage and is usually taken for life.
- All patients need regular monitoring and yearly screening for liver cancer using AFP tests and abdominal ultrasound.
Who Should Receive Treatment
Antiviral treatment is recommended if a patient has any one of these conditions:
- Signs of liver cirrhosis (whether mild or severe) based on examination or APRI score above 2.
- HIV co-infection, managed with a tenofovir-based regimen.
- No cirrhosis but persistent liver enzyme elevation (ALT) on three occasions within 6–12 months and high viral load (>20,000 IU/L), if the test is available.
Recommended Medicines
- Adults and children over 12 years or weighing more than 35 kg: Tenofovir 300 mg once daily.
- Children aged 2–11 years (over 10 kg): Entecavir 0.02 mg per kilogram of body weight once daily.
Who Should Not Be Treated
Patients who:
- Do not have signs of cirrhosis (APRI below 2), and
- Have normal liver enzyme (ALT) levels and a low viral load (<2000 IU/mL)
In such cases, close monitoring is preferred over immediate treatment.
Health Education and Lifestyle Advice
- Management is lifelong, as the infection and its effects need regular follow-up.
- Avoid alcohol, as it worsens liver damage.
- Get enough rest to help the liver recover.
- Household members should be vaccinated against hepatitis B.
- Avoid sharing toothbrushes, razors, needles, and any items that can come into contact with blood or saliva.
Frequently Asked Questions (FAQ)
1. Can chronic hepatitis B be cured?
Most people cannot completely clear the virus, but antiviral medicines can control it and prevent liver damage.
2. How long will I need treatment?
Treatment is often lifelong. Stopping suddenly can cause the virus to become active again and harm the liver.
3. Is hepatitis B contagious?
Yes. It spreads through blood, sexual contact, and from mother to baby at birth. It does not spread through casual contact like hugging or sharing meals.
4. What foods should I eat if I have hepatitis B?
Eat balanced meals rich in fruits, vegetables, and whole grains. Avoid alcohol and fried or fatty foods that can strain the liver.
5. Should my family be tested?
Yes. All household contacts should be tested and vaccinated if they are not already protected.
6. Can I marry or have children if I have hepatitis B?
Yes. You can live a normal life. Your partner and baby can be protected through vaccination and proper medical care.
7. How often should I go for check-ups?
Every 4–6 months, or as advised by your healthcare provider, to monitor your liver and viral load.
