Cancer of the liver is called primary if it arises from the liver itself and is called metastatic if the cancer originates from another body organ.
Hepatocellular carcinoma (HCC) is a primary cancer of the liver and is the fourth leading cause of deaths due to cancer worldwide. One of the causes of HCC is chronic infection of the liver due to the hepatitis B Virus (HBV).
Hepatitis B infection can be acute or chronic. In an acute infection a person can clear the virus and can overcome the disease but some persons develop chronic hepatitis B or long-term/lifetime infection. The liver inflammation can lead to scarring of the liver (cirrhosis) or it can lead to cancer of the liver. Studies have shown that six to 15 percent of patients with chronic hepatitis B infection develop HCC.
HBV infection is a preventable disease. It is blood-borne that can be transferred from one person to another through close contact, sharing of contaminated toothbrushes, manicure or pedicure sets, razors, blood, needles, and other sharp instruments. The HBV can live on objects and instruments for as long as seven days. When an infected person chews food and then gives it to a baby, the virus can be transmitted. The virus can also pass through the placenta to the baby of an infected woman.
Hepatitis B infection can be prevented through immunization. Babies are to be immunized within the first 12 hours of birth if the mother is infected and within 24 hours if the mother is hepatitis B negative. A series of vaccinations will then be given to the infant and should be complete at six to 18 months of age.
In adults there are two basic tests done to check a person’s “hepatitis profile” before vaccination may be started:
Hepatitis B surface antigen (HbsAg): A result that says “positive or reactive” means the person may have acute or chronic HBV infection and can transmit the virus to others. Chronic HBV is characterized by persistently positive or reactive result on two occasions, the tests taken at least six months apart. A negative or non-reactive HBsAg result means the person is not infected and may be immunized; and
Anti-HBs: This will detect if a person has antibodies against hepatitis B virus. Antibodies are formed after a successful vaccination or a person has recovered from an acute infection. It means that his immune system has cleared the virus and he developed these protective antibodies. The level of anti-HBs will guide plans for immunization. A level of 10 or more international units per liter is protective. Less than this confers no protection so that the person should receive a booster dose. A “negative or non-reactive” result means there are no antibodies that protect the person against the virus and should receive vaccination.
Standard vaccination in adults with normal immune system is given as a three-dose series on a zero, one and six-month schedule. In patients with weak immune system, the vaccine is given at a higher dose and is given monthly. Booster doses are administered if the anti-HBs levels are low or the series is repeated if no antibodies are detected.
If you are unvaccinated and you suspect that you were exposed to hepatitis B virus, a dose of hepatitis B immunoglobulin can be given to you within 24 hours of the exposure. Vaccination may then be started depending on your hepatitis B profile.
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