Transmissible and silent infection with hepatitis B (HBV) is still largely under diagnosed and inadequately treated. An intolerable situation when we know that effective treatments exist.

Patients who are unaware …

HBV is spread through sexual contact or blood or from mother to child. In the adult, in 90% of cases, it is removed from the body naturally, leaving only the stigma of living in its path, that is to say, the antibodies identified by serology. But with one in ten patients, hepatitis B is evolving towards a chronic form. Worldwide, approximately 350 million people are affected by chronic hepatitis B, with a particularly high prevalence in Africa, Asia and parts of Latin America.

In France, 280 821 persons are affected by chronic hepatitis B infection. More than half of people infected with hepatitis B are unaware they are infected. For we may be carrying the virus, and therefore invalid, and not suffer any symptoms.

Dramatic consequences

The problem is that the disease remains silent for many years. “The patient with chronic hepatitis B or C does not feel any symptoms for years or even decades, until the stage of life-threatening complications,” explains Professor Marcellin (Hôpital Beaujon, Clichy). These complications are fibrosis, cirrhosis and liver cancer.

The hepatitis B is the second most identified cause of cancer death after tobacco. In France, each year 1 000 to 1 500 people die of HBV infection. In addition, chronic HBV carriers unaware of their status have a significant risk to health personnel and others who may be exposed to their body fluids (blood, sexual secretions). Testing is therefore essential for people at risk.

Should I go get tested?

You have a history – even ancient – repeated hospitalizations you have undergone major surgery, invasive tests (biopsie..) Hospitalization or care for heavy, you have to have tattoos or piercings (especially if done in poor hygiene), you have been transfused before 1992, you have used drugs by injection or snorting, your mother was a carrier of the virus at the time of your birth, your partner or a member of your immediate family is affected by HBV, you went to jail, you’ve done acupuncture sessions, you were born in a region where hepatitis is common (Asia, Africa …)? If you answered yes to even one of these questions, you’ve been infected. It is important to go get tested. A simple blood test is enough. Prescribed by your doctor, the test is supported 100% by Social Security. You can also go into a consultation and free anonymous testing (CDAG).

We must never forget that the sooner the infection is detected, more support is effective. Failing to cure hepatitis B, it is possible to control with drugs active and well tolerated. Over two thirds of infected patients have their disease stabilized thanks to current treatments. And new molecules under development should improve the chances of success. So do not be afraid of you get tested!

According to the Weekly Epidemiological Bulletin of May 19, 2009 (Institute of Health Surveillance) over 500 000 people are carriers of chronic viral hepatitis (232 hepatitis C 000, 281 000 hepatitis B) and nearly 50% do not know and not yet detected. More than 250 000 people living in France with a virus that can potentially destroy their livers.

Without screening, these chronic infections can go completely unnoticed (very few symptoms except fatigue) and lead to severe liver failure or liver cancer, for which no therapeutic use, including transplant is possible.

Over 250 000 people live in France without knowing it, with a bomb in the liver, while there are effective treatments! Viral hepatitis is responsible for 10 times more deaths in France that HIV / AIDS, “says SOS and hepatitis. In addition there are 5000 new infections per year for hepatitis C and 2500 for hepatitis B. Yet , treatment against hepatitis C can cure (viral suppression) in 50% of cases and treatment against hepatitis B can block the virus in more than 80% of cases.

Hepatitis SOS request therefore a generalization of the proposed systematic screening of viral hepatitis, primarily among older transfused, pregnant women, drug users, prisoners, persons of foreign origin residing in France and also those starting a cancer chemotherapy.

This implies, by association, a release of funds by the Ministry of Health to develop a training policy and provision of screening at health care facilities that host populations mentioned above. This implies also the High Health Authority to catch up on the validation of algorithms for detection of hepatitis B and to extend its recommendations to encourage screening for viral hepatitis. Finally, Social Security would pay 100% screening test for hepatitis B.