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1. o Name: khadiijo Yuusuf cali
o Faculty: health science
o Department: laboratory
o Corse lecture: Reseach methodology
o Teacher name: dahir okay
o Assignment hepatitis B virus

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Key terms
1. Definition of hepatitis B virus
2. Causes of hepatitis B virus
3. Transmission of hepatitis B virus
4. Signs and symptoms
5. How to prevent hepatitis B virus
6. Acute and chronic hepatitis B virus
7. Risk factor and Compilation
Hepatitis B virus
Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). For most
people, hepatitis B is short term, also called acute, and lasts less than six months. But
for others, the infection becomes chronic, meaning it lasts more than six months.
Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or
cirrhosis — a condition that permanently scars the liver.
Most adults with hepatitis B recover fully, even if their symptoms are severe. Infants
and children are more likely to develop a long-lasting hepatitis B infection. This is
known as a chronic infection.
A vaccine can prevent hepatitis B, but there's no cure if you have the condition. If
you're infected, taking certain precautions can help prevent spreading the virus to
others.
Symptoms
Symptoms of acute hepatitis B range from mild to severe. They usually appear about 1
to 4 months after you've been infected, although you could see them as early as two
weeks after you're infected. Some people, usually young children, may not have any
symptoms.

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Hepatitis B signs and symptoms may include:
 Abdominal pain
 Dark urine
 Fever
 Joint pain
 Loss of appetite
 Nausea and vomiting
 Weakness and fatigue
 Yellowing of the skin and the whites of the eyes, also called jaundice
Problems
Causes
Hepatitis B infection is caused by the hepatitis B virus (HBV). The virus is passed from
person to person through blood, semen or other body fluids. It does not spread by
sneezing or coughing.
Common ways that HBV can spread are:
 Sexual contact. You may get hepatitis B if you have unprotected sex with
someone who is infected. The virus can pass to you if the person's blood,
saliva, semen or vaginal secretions enter your body.
 Sharing of needles. HBV easily spreads through needles and syringes
contaminated with infected blood. Sharing IV drug paraphernalia puts you
at high risk of hepatitis B.
 Accidental needle sticks. Hepatitis B is a concern for health care workers
and anyone else who comes in contact with human blood.
 Mother to child. Pregnant women infected with HBV can pass88 the virus
to their babies during childbirth. However, the newborn can be vaccinated
to avoid getting infected in almost all cases. Talk to your provider about
being tested for hepatitis B if you are pregnant or want to become pregnant
Acute vs. chronic hepatitis B
Hepatitis B infection may be short-lived, also called acute. Or it might last a long time,
also known as chronic.

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 Acute hepatitis B infection lasts less than six months. Your immune
system likely can clear acute hepatitis B from your body, and you should
recover completely within a few months. Most people who get hepatitis B
as adults have an acute infection, but it can lead to chronic infection.
 Chronic hepatitis B infection lasts six months or longer. It lingers
because your immune system can't fight off the infection. Chronic hepatitis
B infection may last a lifetime, possibly leading to serious illnesses such as
cirrhosis and liver cancer. Some people with chronic hepatitis B may have
no symptoms at all. Some may have ongoing fatigue and mild symptoms
of acute hepatitis.
The younger you are when you get hepatitis B — particularly newborns or children
younger than 5 — the higher your risk of the infection becoming chronic. Chronic
infection may go undetected for decades until a person becomes seriously ill from liver
disease.
Risk factors
Hepatitis B spreads through contact with blood, semen or other body fluids from an
infected person. Your risk of hepatitis B infection increases if you:
 Have unprotected sex with multiple sex partners or with someone who's
infected with HBV
 Share needles during IV drug use
 Are a man who has sex with other men
 Live with someone who has a chronic HBV infection
 Are an infant born to an infected mother
 Have a job that exposes you to human blood
 Travel to regions with high infection rates of HBV, such as Asia, the Pacific
Islands, Africa and Eastern Europe
Complications
Having a chronic HBV infection can lead to serious complications, such as:

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 Scarring of the liver (cirrhosis). The inflammation associated with a
hepatitis B infection can lead to extensive liver scarring (cirrhosis), which
may impair the liver's ability to function.
 Liver cancer. People with chronic hepatitis B infection have an increased
risk of liver cancer.
 Liver failure. Acute liver failure is a condition in which the vital functions of
the liver shut down. When that occurs, a liver transplant is necessary to
stay alive.
 Reactivation of the hepatitis B virus. People with chronic hepatitis B
who have suppression of their immune system are prone to reactivation of
the hepatitis B virus. This can lead to significant liver damage or even liver
failure. This includes people on immunosuppressive medications, such as
high-dose corticosteroids or chemotherapy. Before taking these
medications, you should be tested for hepatitis B. If you test positive for
hepatitis B, you should be seen by a liver specialist (hepatologist) before
starting these therapies.
 Other conditions. People with chronic hepatitis B may develop kidney
disease or inflammation of blood vessels.
The best way to prevent hepatitis B is to get vaccinated. All adults aged 18-59
should receive the vaccine and any adult who requests it may get the
vaccine. All adults 18 years and older should get screened at least once in
their lifetime.
Prevention
The hepatitis B vaccine is typically given as two injections separated by a month or
three or four injections over six months, depending on which vaccine is given. You
can't get hepatitis B from the vaccine. The hepatitis B vaccine is recommended by the
United States Advisory Committee on Immunization Practices for adults 19 to 59 years
of age who do not have a contraindication to the vaccine.
The hepatitis B vaccine is also strongly recommended for:
 Newborns
 Children and adolescents not vaccinated at birth
 Those who work or live in a center for people who are developmentally
disabled

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 People who live with someone who has hepatitis B
 Health care workers, emergency workers and other people who come into
contact with blood
 Anyone who has a sexually transmitted infection, including HIV
 Men who have sex with men
 People who have multiple sexual partners
 Sexual partners of someone who has hepatitis B
 People who inject illegal drugs or share needles and syringes
 People with chronic liver disease
 People with end-stage kidney disease
 Travelers planning to go to an area of the world with a high hepatitis B
infection rate
Screening and Testing
 2023 Screening and Testing Recommendations
 Testing and Vaccination
 Serology
Vaccination of Infants and Children
 Guidelines and Recommendations
 Schedules and Dosages
 Standing Orders
Vaccination of Adults
 Guidelines and Recommendations
 Adults recommended to receive HepB vaccine
 Implementation Guideline
NAIIS Call to Action

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Background study
Viral hepatitis b in the world or Global
Hepatitis B Affects Millions of People Around the World
 Hepatitis B affects approximately 296 million people, including over 6
million children under the age of 5.
 Hepatitis B contributes to an estimated 820,000 deaths every year.
 25% of chronic hepatitis B infections progress to liver cancer.
Hepatitis B Causes Serious, Lifelong Health Problems
Hepatitis B is the leading cause of liver cancer globally. It can also cause:
 Liver damage
 Cirrhosis
 Liver failure
 Death
Hepatitis B virus in th African
More than 91 million Africans live with Hepatitis B or C, which are the deadliest
strains of the virus, according to a World Health Organization (WHO)
scorecard that launched today – ahead of tomorrow’s World Hepatitis Day.
The Viral Hepatitis Scorecard 2021 looks at data from the African
region but focuses on Hepatitis B and C, both of which cause liver cirrhosis and
cancer. It found that in 19 countries, more than 8% of the population is infected
with Hepatitis B, while in 18 countries, more than 1% of the population
lives with Hepatitis C. In 2020, the African region accounted for 26% of the global
burden for Hepatitis B and C and 125,000 associated deaths.

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Around 70% of Hepatitis B infections worldwide occur in Africa. It can take decades
after infection from the virus before an individual starts manifesting symptoms.
Thus, what is particularly worrying for the future is that the region accounts for 70%
of the global Hepatitis B cases found among children younger than 5 years, with 4.5
million African children infected. Currently, 33 countries have a Hepatitis B
prevalence of more than 1% among children younger than 5 years, which is a small
improvement from 40 countries in 2019.
Hepatitis B virus in somalia
Hepatitis A is a liver disease caused by HAV, and it occurs
worldwide. This virus thus creates a public health concern,
primarily in developing countries, due to its persistent
circulation in the environment. Among the studies presented in
Somalia, more than 90% of children had the HAV antibody by
the age of 4 years[15-19]. In 1992, Mohamud KB and his
colleagues studied a Somali sample of 593 subjects who were
healthy rural and urban volunteers and child outpatients ages 0-
83 years in three villages in Somalia (Mogadishu area: Buur-
Ful village; Jowhar District: Mooda Moode; and Bur-Hakaba
District and Bajuni Islands: Kismaio District). This sample
showed a very high rate of HAV exposure of approximately
90%[15]. Another study by Bile et al[16] conducted at two
institutions for children in Somalia (Shebeli: 596 subjects and
Societe Organization Social, SOS: 76 subjects) showed a very
high rate of HAV in the two samples of 96% and 59%,
respectively. One study indicated that HAV in Somalia occurs
primarily between 4 mo to 4 years of age, because the child has
passive immunity from maternal antibodies during the first 3
mo of life[17]. Sebastiani et al [18] presented a result of 90.6%.
Recommendation

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Hepatitis B Vaccine Recommendations
International: The World Health Organization (WHO) recommends the hepatitis B vaccine for
all newborns, children up to 18 years of age, and all adults at higher risk for infection (see
below for risk factors).
United States: The U.S. Centers for Disease Control and Prevention (CDC) recommends the
hepatitis B vaccine for all newborns, children up to age 18, adults 19-59 years of age, and
adults 60 and older who are at high-risk for infection (see below for risk factors)
Persons most at risk for infection:
Every person may be at some risk for a hepatitis B infection during their lifetime, so all people
should consider getting the hepatitis B vaccine. However, some groups are more likely to be
exposed to the hepatitis B virus. See below for the CDC’s list of people at increased risk of
infection:
 Infants born to mothers who are living with hepatitis B
 All infants, beginning at birth
 Unvaccinated children aged <19
 Susceptible sexual partners of people with hepatitis B infection
 Sexually active persons who are not in a long-term, mutually monogamous
relationship (e.g., more than one sex partner during the previous six months)
 Persons seeking evaluation or treatment for a sexually transmitted infection
 Men who have sex with men
 People with current or recent drug use
 Susceptible household contacts of people with hepatitis B infection
 Healthcare and public safety workers at risk for exposure to blood
 Persons with end-stage renal disease, including pre-dialysis, hemodialysis, peritoneal
dialysis, and home dialysis patients
 Residents and staff of facilities for persons with developmental disabilities
 Travelers to and families adopting from countries where hepatitis B is common (e.g.
Asia, Africa, South America, Pacific Islands, Eastern Europe, and the Middle East)
 Persons with chronic liver disease, other than hepatitis B (e.g. cirrhosis, fatty liver
disease, etc.)
 Persons with hepatitis C infection
 Persons with HIV infection

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 People with diabetes, as decided by their provider
 All persons seeking protection from HBV infection — acknowledgment of a specific
risk factor is not a requirement for vaccination
Conclusion
Our study demonstrates a high prevalence of all forms of viral hepatitis in
Somalia and it also indicates that chronic HBV was the commonest cause of
chronic liver disease. This highlights needs for urgent public health interventions
and strategic policy directions to controlling the burden of the disease.
Keywords: Viral hepatitis, Hepatitis A virus, Hepatitis B virus, Hepatitis C virus,
Hepatitis D virus, Hepatitis E virus, Systematic review, Meta-analysis, Somalia
Core tip: This is the first article reviewing epidemiology of viral hepatitis in
Somalia with systematic review and meta-analysis of the published and
unpublished reports from 1977 to 2016 among prevalence of all types’ viral
hepatitis in Somalia.