With an estimated 20 million Nigerians living with Hepatitis B Virus (HBV), a renowned professor of Gastroenterology, and Hepatology, University of Ibadan, Jesse Otegbayo has called for the integration of the HBV vaccine into the National Programme on Immunisation.

Otegbayo, who suggested this at the 548th Inaugural Lecture of the University of Ibadan, said several countries including Nigeria are signatories to the inclusion of the HBV vaccine in the National Programme on Immunisation, adding that the degree of implementation and compliance has been low.

He also stressed the need for concrete action towards healthcare reform, urging the implementation of universal healthcare and strategies to address the increase in the number of the virus spread.

According to him, accurate, sensitive, and specific tools are deficient for the early detection of liver cancer and many existing methods are relatively expensive, invasive, or limited in accessibility.

“The liver has appropriately ascribed the appellation of the body workhorse or powerhouse of the whole body because it is known scientifically to play crucial roles in carbohydrate, fat, protein, vitamins, and mineral metabolism, regulation of blood clotting, immunity, and many others. It is known to perform over 500 functions in the body,” he said.

While non-hepatotropic viruses affect the liver and cause milder diseases, hepatotropic viruses are responsible for about 90 per cent of the causation of liver diseases and these viruses form an alphabet soup according to the time they were discovered. There are Hepatitis A virus (HAV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Hepatitis D Virus (HDV), and Hepatitis E Virus (HEV).

He said: “The difference between the two groups is mainly in the severity of the disease they cause in the liver. Hepatotropic viruses bite the liver and lick other organs, non-hepatotropic viruses lick the liver and bite other organs and collectively, they cause viral hepatitis, which is defined as virally mediated liver inflammation.”

The professor emphasised that all the hepatotropic viruses have been tested and found to be abundantly present in Nigerian patients with various health conditions, pregnancy, and even in those who are healthy individuals.

He observed that among the four viruses, Hepatitis B has the most devastating effect on the environment, with the capacity to deliver a toxic and fatal sting on the liver.

“Hepatitis B Virus has a complex biology, consisting of a partially double-stranded DNA and many antigenic determinants and antibodies that have been found useful in the diagnosis of infection and the level of protection of an individual that has either been previously exposed or has been immunised.”

Otegbayo noted that the prevalence rate of HBV in Nigeria, ranges from six per cent to 25 per cent and more than 20 million people are living with hepatitis B, C, or both; yet more than 80 per cent of the people who have the disease do not know their status.

“About 12 per cent of patients with HIV in Ibadan, Oyo State, have been found to have a co-infection with HBV, therefore compounding the problem of treatment of both viruses,” he said.

He explained that the HBV virus in its transmissible form is found in all body fluids, such as blood, semen, saliva, sweat, urine, and bile, while the most effective means of transmission is however, blood and blood products.

“Because the organism is highly infectious, only a small quantity of fluid is required to transmit the infection, and in fact, HBV is about 100 times as infectious as the dreaded HIV and could survive for as long as six weeks on a dry surface,” he added.

MEANWHILE, a new study suggests that proteins detectable in the blood could improve predictions about the risk of liver cancer years before typical diagnosis.

The study led by scientists from Mass General Brigham and Beth Israel Deaconess Medical Centre and published in the Journal of the National Cancer Institute (JNCI) has the potential to transform treatment and outcomes in oncology care, especially for cancers like liver cancer, which is usually diagnosed at a late stage with limited options for cure.

For the study, the team utilised the study of the interactions, function, composition, and structures of proteins and their cellular activities known as proteomics to develop a prediction model aimed at screening for liver cancer at an earlier stage using the SomaScan Assay Kit.

The kit is a platform that measures protein levels in biological samples, and this allowed them to detect minute levels of circulating proteins that may be present at the early stage of disease, measuring 1,305 proteins simultaneously in the blood.

They examined blood samples obtained from individuals an average of 12 years before their liver cancer diagnosis to pinpoint protein biomarker signals. After examination, the researchers cross-referenced medical records to confirm whether the patients developed liver cancer from the blood samples.

They identified 56 plasma proteins that showed significantly elevated levels in individuals with liver cancer compared to matched control individuals without the cancer. The team selected four of these proteins to create a predictive model and tested it using the UK Biobank Pharma Proteomics dataset which comprised 50,000 individuals, 45 of whom were diagnosed with liver cancer.

The co-author and Professor, Division of Interdisciplinary Medicine and Biotechnology at the centre, Towia Libermann, said, “It’s always been challenging to identify highly specific disease biomarkers in the blood using traditional tools, but this new technology allows us to detect a broad and dynamic range of both high and low abundant proteins. New insights into the biological mechanisms underlying liver cancer development emerge from our data that may lead to the identification of novel therapeutic targets.”

Although their model had greater accuracy in predicting liver cancer compared to traditional risk factors, the authors caution that their study included a limited number of liver cancer cases therefore further validation in larger, more diverse patient populations and high-risk populations is needed.

Liver cancer ranks as the third leading cause of cancer worldwide and the second leading cause of cancer-related deaths globally, with its incidence rate nearly tripled since the 1980s in the US. Detection of liver cancers often occurs at advanced stages, where life expectancy typically spans less than 12 months. Certain high-risk populations, such as individuals with cirrhosis and hepatitis, stand to significantly benefit from early detection tests.