On the occasion of World Hepatitis Day, Dr Ombolo Fernand, discusses the silent nature of hepatitis B and C, the importance of early screening, the treatment options currently available in Cameroon and the misconceptions that continue to delay care.Dr Ombolo Fernand, hepatologist and gastroenterologist at Biyem-Assi District Hospital in Yaounde
Doctor, many people have heard about hepatitis, but very few actually know what hepatitis B and C are. Could you explain these diseases?
Hepatitis B and hepatitis C are viral infections caused by the hepatitis B and C viruses. They attack the liver and cause inflammation. What makes these infections particularly dangerous is their long-term evolution. If they are not detected and managed early, they can progressively damage the liver and eventually lead to cirrhosis or liver cancer, which are among the most serious complications we see in clinical practice.
How do these viruses spread?
Hepatitis B is commonly transmitted from an infected mother to her child during childbirth if appropriate preventive measures are not taken. It is also transmitted through contact with infected blood and through unprotected sexual intercourse. Hepatitis C is mainly spread through blood exposure, for example by sharing needles, razor blades or other sharp objects, or through poorly sterilized medical equipment. Sexual transmission is also possible, although it is less common than with hepatitis B.
People should understand that body fluids can transmit the virus, particularly sexual fluids. However, we also need to be accurate: the risk of transmission through saliva or sweat is much lower than through blood or sexual contact.
During our discussion, you said something striking: “The main risk factor is ignorance.” Why?
Because many infections could be prevented if people simply knew how hepatitis is transmitted. Some do not realize that a mother can pass hepatitis B to her baby. Others underestimate the risks associated with unprotected sex or sharing sharp objects. Sometimes people are exposed during procedures performed with inadequately sterilized equipment. Raising awareness is therefore just as important as providing treatment.
Who should be particularly vigilant?
Everyone should know their hepatitis status, but some groups deserve special
attention. These include healthcare workers, people with multiple sexual partners, people living with HIV, patients who require repeated blood transfusions, those on dialysis and individuals exposed to blood through their work or medical conditions. Adults between 25 and 49 years of age also represent a significant proportion of new infections because they are generally the most sexually and professionally active.
Many people wait until they feel ill before seeking medical advice. Why is this a mistake?
Because hepatitis rarely produces specific symptoms at the beginning. Patients may feel tired, have body aches or a slight fever, symptoms that can easily be mistaken for malaria or another common illness. Some have no symptoms at all.
Unfortunately, when obvious signs such as jaundice, abdominal swelling, weight loss or severe pain appear, the disease has often progressed to cirrhosis or even liver cancer. That is why we insist on screening. Early diagnosis allows us to intervene before irreversible damage occurs.
Can hepatitis B and C be treated successfully today?
Absolutely. Hepatitis B cannot usually be completely eliminated, but we have effective antiviral medicines that suppress the virus and prevent disease progression. Hepatitis C is different. In most patients, it can now be cured with direct-acting antiviral medicines taken over a period of three to six months, depending on the clinical situation.
This is one of the greatest advances we have witnessed in liver medicine over the past decade.
Are these treatments accessible in Cameroon?
Yes, access has considerably improved. For hepatitis B, treatment is available in accredited treatment centers at around 2,000 CFA francs per month. Considering that it is a chronic disease requiring long-term therapy, this is a major achievement.
Treatment for hepatitis C remains more expensive. Patients should expect to pay around 100,000 CFA francs per month for three to six months. This is still a challenge for many families, but we should remember that not so long ago these medicines cost several million CFA francs. The situation has improved enormously.
What are the biggest challenges you still face when caring for patients?
The biggest difficulty is not necessarily getting patients to take their medicines. It is
seeing them arrive too late. When someone already has cirrhosis, we are no longer treating only hepatitis. We also have to manage complications affecting the liver, kidneys, heart and other organs. That makes treatment much more complex and much more expensive.
Patients diagnosed while they are still asymptomatic generally have a much better prognosis.
What misconceptions continue to delay diagnosis and treatment?
One common misconception is that hepatitis only affects people with so-called risky lifestyles. That is false. Another is that if you feel healthy, you cannot have hepatitis. That is also false because these infections can remain silent for years.
Some people even believe that a diagnosis means there is nothing that can be done. Today, that is simply not true. We have treatments that can control hepatitis B and medicines capable of curing hepatitis C in most patients.
As the world marks World Hepatitis Day, what message would you like to leave to the Cameroonian population?
My message is simple. Do not wait until symptoms appear. Get tested, know your hepatitis status and seek medical advice as early as possible if you are at risk. Early diagnosis saves lives, prevents liver cancer and gives patients the best chance of living a healthy life.
