Health experts warn hepatitis B remains a silent epidemic in Kenya

As Kenya joins the world to commemorate World Hepatitis Day, scientists and health experts are raising concern over hepatitis B, which has remained silent despite it being highly infectious.

In interviews with The Standard, the experts regret that many people living with hepatitis remain undiagnosed because the infection often causes no symptoms in its early stages or presents with signs that resemble common illnesses.

Dr Missiani Ochwoto, a virologist and medical research scientist at the Kenya Medical Research Institute (KEMRI), attributes the country's slow progress in tackling hepatitis to stigma, inadequate diagnostic capacity, low public awareness and chronic underfunding.

"Hepatitis is among the leading infectious killers, yet funding remains far below that allocated to HIV, tuberculosis and malaria," says Dr Ochwoto.

There are five types of viral hepatitis in Kenya, namely hepatitis A, B, C, D and E.

However, hepatitis B and C remain the biggest public health concern because they are transmitted in ways similar to HIV, including from mother to child, through unprotected sex and exposure to infected blood and other body fluids.

According to the Head of Viral Hepatitis and STIs at the National AIDS and STI Control Programme (NASCOP), Dr Hadija Hassan, the disease has remained a silent epidemic because it has received little attention despite its devastating impact.

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If left untreated, hepatitis B and hepatitis C can become chronic infections that progressively damage the liver, leading to fibrosis, cirrhosis and eventually liver cancer.

Liver cancer is the second leading cause of cancer deaths in Kenya.

Data from the Kenya Population-based HIV Impact Assessment (KEPHIA), hepatitis B prevalence in Kenya stands at about three per cent, the same as HIV prevalence.

However, some counties carry a much higher burden, with Turkana recording the highest prevalence at 16 per cent, followed by West Pokot at 11 per cent and Baringo at 10.8 per cent.

Hassan notes that counties in northern Kenya also continue to report a high burden of hepatitis B.

The burden of hepatitis C is highest in parts of the Coast region; for instance, Lamu has the highest reported prevalence at 29 per cent, followed by Mombasa at 25 per cent and Nairobi at 12 per cent.

Hassan explains that Hepatitis C infections are most common among people who inject drugs, mainly because of the unsafe sharing of needles and syringes.

Dr Hassan adds that counties with a high HIV burden, including Migori, Homa Bay, Nakuru and other parts of the Nyanza region, are also reporting cases of hepatitis and HIV co-infection.

"Viral hepatitis has been a silent epidemic because many infected people do not experience symptoms until the disease has advanced,” says Dr Hassan.

She adds: “About 1.9 million Kenyans are estimated to be living with chronic hepatitis, yet the majority do not know they are infected due to low screening uptake, limited public awareness and stigma."