Hepatitis B​—A Silent Killer

“I was 27 years old, recently married, and I looked and felt healthy. I was holding down a high-pressure job while caring for many responsibilities in the local congregation of Jehovah’s Witnesses. I was unaware that hepatitis B had begun to destroy my liver.”​—Dukk Yun.

THE liver filters poisons from the blood and performs at least 500 other important functions. That is why hepatitis​—inflammation of the liver—​can devastate a person’s health. Hepatitis may result from excessive alcohol consumption or exposure to toxins. Most often, though, viruses are the culprit. Scientists have identified five such viruses and believe that there are at least three more.​—See the  box below.

Just one of the five​—hepatitis B virus (HBV)—​kills at least 600,000 people a year,  comparable to the toll taken by malaria. More than two billion people​—nearly a third of the world’s population—​have been infected with HBV, and most recovered within months. For about 350 million, however, the disease became chronic. For the rest of their lives, whether they have symptoms or not, they will have the potential to infect others. *

Proper medical care, started early, can help some with chronic HBV to ward off serious liver damage. But most are unaware that they have been infected, as only a specific blood test can detect HBV. Even routine liver function tests may come back normal. Thus, HBV can be a silent killer, striking without warning. Obvious symptoms may not appear until decades after infection. By then, either cirrhosis or cancer of the liver may have developed. These diseases take the life of 1 in 4 HBV carriers.

“How Did I Get HBV?”

“My symptoms first occurred at age 30,” says Dukk Yun. “I had diarrhea, so I went to a doctor of Western medicine, but he treated only the symptoms. I then saw a traditional Asian doctor, who gave me medicine for my intestines and stomach. Neither doctor checked for hepatitis. Because the diarrhea persisted, I returned to the Western doctor. * He gently tapped the right side of my abdomen, which caused me pain. A blood test confirmed his suspicion​—I was carrying the hepatitis B virus. I was shocked! I had never had a blood transfusion, nor had I been sexually promiscuous.”

After Dukk Yun learned that he had HBV, his wife, parents, and siblings had their blood tested, and all had antibodies to HBV. In their case, however, their immune systems had cleared the virus from their bodies. Had Dukk Yun acquired HBV from one of them? Had they all been exposed to a common  source? No one can be sure. Indeed, in about 35 percent of cases, the cause remains a mystery. What is known, though, is that hepatitis B is not hereditary and is virtually never acquired through casual contact or the sharing of food. Rather, HBV is spread when blood or other body fluids, such as semen, vaginal secretions, or saliva from an infected person, enter another’s bloodstream through broken skin or mucous membranes.

Transfusions of contaminated blood continue to infect many, especially in countries where screening for HBV is limited or nonexistent. HBV is 100 times more infectious than HIV, the virus that causes AIDS. Even a tiny amount of infected blood, such as may be found on a razor, can pass on HBV, and a dried bloodstain can remain infectious for a week or more. *

The Need for Understanding

“When my company learned I had HBV, they put me in a small office away from most of my colleagues,” recalls Dukk Yun. Such treatment is not uncommon and may spring from a misunderstanding of how the virus spreads. Even otherwise well-informed people may confuse hepatitis B with hepatitis A, which is highly contagious but less life threatening. Further, since HBV can be transmitted sexually, even morally upright sufferers are sometimes viewed with suspicion.

Misunderstandings and suspicion can create serious problems. For example, in many places people needlessly ostracize HBV carriers, young and old. Neighbors do not allow their children to play with them, schools do not admit them, and employers avoid hiring them. Fear of discrimination, in turn, keeps people from getting tested for HBV or revealing that they have the disease. Some even risk their own future health and that of family members rather than disclose the truth. Thus, the deadly cycle of the disease can continue for generations.

The Need for Rest

“Although my doctor prescribed complete rest, after two months I returned to work,” relates Dukk Yun. “Blood tests and CT scans showed no sign of cirrhosis, so I thought I was fine.” Three years later, his company transferred Dukk Yun to a big city, where his life became more stressful. With bills to pay and a family to support, he kept working.

Within months, the virus count in Dukk Yun’s blood shot up and he began to feel exhausted. “I had to quit my job,” he said, “and I now regret that I worked so hard. If  I had slowed down sooner, I might not have become so sick, further damaging my liver.” Dukk Yun learned a vital lesson. From then on, he cut back his work and his expenses. Moreover, his whole family cooperated, his wife even taking on a small job to help make ends meet.

Living With Hepatitis B

Dukk Yun’s health stabilized, but his liver increasingly resisted the blood flowing through it, elevating his blood pressure. After 11 years, a vein in his esophagus burst and blood gushed from his throat, sending him to the hospital for a week. Four years later, he experienced mental confusion. Ammonia had built up in his brain because his liver could no longer filter it all out. Medical treatment, however, corrected the problem in a few days.

Dukk Yun is now 54. If his condition worsens, his options are limited. Antiviral treatments cannot clear the virus entirely and may have serious side effects. The last option is a liver transplant, but the waiting list is longer than the donor list. “I’m a ticking time bomb,” says Dukk Yun. “But it does no good to brood about it. I still have life, a place to sleep, and a fine family. In fact, in some ways, my condition has turned out to be a blessing in disguise. I have more time to spend with my family and more time to study the Bible. This calms my fear of untimely death and helps me to look forward to life without illness.” *

Thanks in part to Dukk Yun’s positive outlook, his family enjoys a happy life and he, his wife, and their three children all share in the full-time Christian ministry.

[Footnotes]

[Blurb on page 13]

Early medical care can help ward off damage

[Blurb on page 14]

Fear of discrimination keeps many from getting tested or revealing that they have HBV

[Box on page 12, 13]

 WHAT TYPE OF HEPATITIS IS IT?

Five viruses are known to cause hepatitis, the three most common being designated A, B, and C. Other viruses are also suspected. The symptoms of all forms of hepatitis can be flulike and may or may not include jaundice. Many people, particularly children, have no symptoms. With hepatitis B and hepatitis C, the liver may already be severely damaged by the time symptoms appear.

HEPATITIS A VIRUS (HAV)

HAV is present in the feces of an infected person. The virus can survive in salt or fresh water and in ice cubes. A person can come in contact with HAV by

● Eating uncooked seafood from water contaminated with human waste or ingesting contaminated water

● Having close physical contact with an infected person or sharing food, drink, or eating utensils with him

● Not washing hands thoroughly after using the toilet or changing an infected baby or before preparing food

HAV causes acute but usually not chronic illness. In almost all cases, the body clears itself of the virus within weeks or months. There is no specific standard treatment besides rest and adequate nutrition. Alcohol, as well as drugs that burden the liver, such as acetaminophen, should be avoided until a doctor determines that the liver is completely healed. A person who has had HAV will probably not get it again but can get other types of hepatitis. Vaccination can prevent hepatitis A.

HEPATITIS B VIRUS (HBV)

HBV is present in the blood, semen, and vaginal fluids of infected people. The virus spreads when these fluids enter the body of someone who is not immune. The virus can be transmitted by

● Birth (from an infected mother to her baby)

● Medical, dental, tattooing, or body-piercing instruments that have not been properly sterilized

● Shared hypodermic needles, razors, nail files or clippers, toothbrushes, or anything else that can transfer even a tiny amount of blood through any break in the skin

● Sexual activity

Health authorities believe that HBV is not spread by insects, or by coughing, holding hands, hugging, kissing on the cheek, breast-feeding, or sharing food, drink, chopsticks, or other eating utensils. Most adults recover from acute HBV and will then be immune to it. Small children are at high risk of developing chronic infection. Untreated, chronic hepatitis B can lead to liver failure and death. Vaccination can prevent hepatitis B.

HEPATITIS C VIRUS (HCV)

HCV is transmitted in much the same way as HBV but most commonly by the injection of drugs with contaminated needles. There is no vaccine for hepatitis C. *

[Footnote]

[Box on page 14]

BREAKING THE HBV CYCLE

Although HBV affects people worldwide, about 78 percent of those with chronic hepatitis B live in Asia and the Pacific islands. In much of that region, 1 person in 10 is a carrier. Most sufferers there acquire the virus at birth from their mother or early in childhood from contact with the infected blood of other children. An effective vaccine for newborns and others who are at risk is helping to break this cycle. * Where vaccination has been implemented, prevalence of the disease has plummeted.

[Footnote]

[Picture on page 15]

Dukk Yun with his wife and three children

[Picture Credit Line on page 12]

© Sebastian Kaulitzki/​Alamy