*Ignorance fuelling spread of hepatitis B Epidemic in Asia*

30 Oct 2007 03:48:48 GMT
Source: Reuters

By Tan Ee Lyn

HONG KONG, Oct 30 (Reuters) - Ignorance is fuelling the spread of
hepatitis B in Asia, where patients are failing to get proper treatment
and not enough is done to reduce transmission of the virus from mother
to child, an expert said.

The 10th leading cause of death worldwide, chronic hepatitis B affects
360 million people globally.

Of these, 281 million are in Asia, and one out of every four of them
will die from either cirrhosis -- scarring of the liver -- or liver
cancer later in life.

Symptoms such as jaundice, fatigue, abdominal pain, loss of appetite,
nausea and joint pain may not surface in 30 percent of cases, and they
are even less common in children.

As such, many people usually don't know they are infected until it is
too late, and those who do have little impetus to get treated or have
regular check-ups, according to the results of a survey carried out in
10 places in Asia this year.

"Ignorance helps the transmission of the disease and the survey finds
this ignorance results in people giving up on the chance of proper
treatment ... they don't think it's important to be treated because they
don't have symptoms," said Nancy Leung, an expert on the disease and
associate professor at the Chinese University's department of medicine
and therapeutics.

The survey covered 1,500 people diagnosed with chronic hepatitis B in
China, Hong Kong, South Korea, Malaysia, the Philippines, Indonesia,
Singapore, Taiwan, Thailand and Vietnam and who were taking anti-viral
drugs to suppress the virus.

Although 77 percent of them said they knew "an average or a great deal"
about the disease, substantial numbers of them (36 and 27 percent,
respectively) were unaware that the main routes of transmission were
from mother-to-child and through sex.

Overwhelming numbers mistook hepatitis B for hepatitis A, with 73
percent in China, 70 percent in the Philippines and 63 percent in
Singapore thinking that "eating infected food" was the major cause.

Thirty-eight percent did not know how they came to be infected. In China
and the Philippines, 53 percent and 46 percent thought they caught the
virus from food.

In Indonesia and Vietnam, 57 percent and 44 percent cited "poor health"
as the cause.

Highlighting the seriousness of the disease, Leung said 10 percent of
Hong Kong's 7 million strong population, or 700,000 people, suffer from
chronic hepatitis B. And despite the city's advanced health care system,
only a fraction of patients are getting adequate care.

"In Hong Kong, less than 10 percent of patients with chronic hepatitis B
are being treated, only 20 percent are being properly monitored and
assessed," Leung said.

Almost all chronic hepatitis B sufferers were infected before they were
born or when they were very young.

In Hong Kong, 60 percent of sufferers are believed to have been infected
by their mothers, while 40 percent were infected when they were very
young, usually through blood contact with infected playmates via open
sores and small breaks in the skin.

"Infections in adulthood would in all likelihood not be chronic, they
would be cured," said Leung, referring to the intense immune response
such an infection would trigger in an adult, who would be able to get
rid of the virus completely.

Conversely, in an infant or a very young child, they are very often
unable to flush out the virus, and it remains in their livers,
multiplying and then creating havoc over time.

Pregnant mothers who are carriers of the disease must inform their
doctors and infants can be effectively protected if they are given a
vaccine and hepatitis B immune globulin within 12 hours after birth. A
second dose is given 1-2 months later and a third dose at age 6 months.