Viral Hepatitis B

Viral hepatitis B is a liver infection caused by the hepatitis B virus, which can be acute or become chronic. Chronic infection can lead to serious long-term complications, including cirrhosis and liver cancer, and Tanzania has a moderate to high burden of hepatitis B.

• Acute infection: fatigue, loss of appetite, nausea, mild fever, abdominal discomfort, and yellowing of the skin and eyes (jaundice) — many acute infections, especially in young children, cause no noticeable symptoms
• Chronic infection: often asymptomatic for years, sometimes with mild fatigue, until advanced liver disease develops
• Signs of advanced liver disease: jaundice, abdominal swelling, and easy bruising or bleeding

• Caused by the hepatitis B virus, transmitted through contact with infected blood or body fluids.
• Transmission occurs from mother to child during birth, through unprotected sexual contact, and through contact with contaminated blood or unsterile medical or cosmetic equipment (such as shared needles or unsterilised piercing/tattoo tools).
• Infection acquired in infancy or early childhood is much more likely to become chronic than infection acquired as an adult.

• Diagnosed with a blood test for hepatitis B surface antigen (HBsAg); a positive result present for more than six months indicates chronic infection.
• Further blood tests (such as HBeAg, viral load, and liver function tests) help assess disease activity and guide the need for treatment.
• Liver ultrasound and other assessments may be used to check for cirrhosis or early signs of liver cancer in chronic infection.

Acute hepatitis B usually requires only supportive care — rest, adequate fluids and nutrition, and avoiding alcohol — since most adults clear the infection on their own.

Chronic hepatitis B with evidence of significant liver disease activity is treated with a long-term oral antiviral medicine, such as tenofovir, which suppresses the virus and reduces the risk of progression to cirrhosis and liver cancer.

All pregnant women are tested for hepatitis B, and infants born to hepatitis B-positive mothers receive a birth dose of hepatitis B vaccine (and immunoglobulin where available) to prevent mother-to-child transmission.

People with chronic hepatitis B require regular follow-up, including monitoring for liver cancer, even if not currently on antiviral treatment.

• Complete the routine infant hepatitis B vaccination series, including the birth dose.
• Screen pregnant women for hepatitis B as part of antenatal care.
• Avoid sharing needles, razors, or other items that may carry blood.
• Ensure medical, dental, and cosmetic procedures use properly sterilised equipment.
• Use condoms consistently to reduce sexual transmission.
• Avoid alcohol if living with hepatitis B, as it accelerates liver damage.