DR.HAMEED OLADIPUPO is a consultant Gastroenterologist and Hepatologist and a member of the Nigerian Society of Gastroenterology and Hepatology in Nigeria (SOGHIN).Oladipupo explains, in this interview with NIGERIAN HEALTH JOURNAL the basics of Hepatitis treatment and provides some information to guide patients undergoing treatment for Hepatitis.
At what point would someone require treatment for Hepatitis
Treatment could be required at any point because it is difficult to predict when liver cancer can occur. Once the virus has been detected through a test; treatment should be planned.
It is often believed that treatment is more than just giving drugs. What does treatment entails with respect to Hepatitis B
Treatment entails health education about transmission to others, preventing the disease from worsening, taking medication to prevent progression to liver cancer and finally treating cancer once it has evolved.
What is the implication of not adhering to your drug prescription when on medication for Hepatitis?
Treatment failure may occur, development of resistance and of course liver failure or liver cancer may still occur.
How long can a patient remain on Hepatitis treatment once initiated?
This depends on treatment choice, it could last just one year or it could be for life.Treatment choice means what is best for the patient in terms of a doctor’s evaluation. This must be made with the patient’s agreement. The doctor cannot decide unilaterally for the patient. The choices I had discussed earlier in terms of Interferon treatment or nucleoside analoguetreatment. Also,if there has been some damage or the patient and his doctor decide to use nucleoside analogues the patient may have to be on therapy for life
When can we say treatment has failed and what are the signs of treatment failure when treating for Hepatitis?
Treatment failure can be detected by raising levels of the Hep B viral load when on treatment or post treatment to values above 2000IU.
What classes of Hepatitis patients are at risk of not doing well when placed on treatment?
Patients with extremely high viral load, patients who already have some liver damage also may not do well. Others are people with co infections HIV,Hep D virus,or Hep C virus.
What drugs are used for hepatitis treatment and how does it act on the Hepatitis virus?
We basically have 2 groups of drugs: the first is the interferons that suppress the viral load and strengthen the immune system to help the body clear the virus. The other groups are the Nucleoside analogues that are strong suppressors of the virus.
What is the implication of co-morbidity or Hepatitis co-infection* on treatment outcomes?
What are some of the national policies that can improve the quality of Hepatitis treatment and management in Nigeria?
We need the government to encourage free screening of Nigerians and proper data collection for us to know just how many people are infected with Hepatitis B in Nigeria. Also government needs to subsidize treatment so that every infected person gets the treatment they need. Lastly we need to improve on vaccination of our population.
What specific roles can treatment literacy play in improving outcomes for patients undergoing treatment for Hepatitis?
This helps the people undergoing treatment have clear expectations on what can be done, what is achievable etc.
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