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New Study Finds Stark Differences in Hep B Virus in High, Low Endemic Districts

Now, a team of researchers from the Makerere University College of Microbiology and Biochemistry have recommended to the government to change treatment regimens to suit the kind of virus circulating in particular areas other than giving blanket treatment guidelines, which could breed drug resistance.
Principal Investigator Mukasa Kafeero (Center) at the Results Dissemination Event in Kampala.

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Northern region has more aggressive strains of hepatitis B – Hep B compared to what is circulating in low endemic areas of Eastern and South Western Uganda. This is part of the findings in Uganda’s first study to determine the strains of hepatitis B – Hep B circulating in the country. 

Now, a team of researchers from the Makerere University College of Microbiology and Biochemistry have recommended to the government to change treatment regimens to suit the kind of virus circulating in particular areas other than giving blanket treatment guidelines, which could breed drug resistance.

Mukasa Kafeero, the lead investigator says that while the Ministry of Health (MOH) cited the A strain to be the most dominant, their study found the D strain in high endemic areas and a combination of the E and D strains and recombined strain ED in low endemic areas.

//Cue in:” Different regions must ………..       

Cue out ……… in the south”. //  

The commonly used antiviral drug Nevirapine also used in HIV treatment may not work well for Hep B sufferers in the north, according to the researcher.

//Cue in:|” The medication to …………     

   

Cue out: ………… are very expensive”. //  

Generally, while not all people who test Hep B positive need treatment, another microbiologist Prof. Moses Joloba, says that there is need for continued surveillance to determine circulating genotypes since they found 65.9% of the people in low Hep B needed treatment and another 60% in the high endemic areas in need of treatment.

With a national prevalence average of 4.3%, MOH statistics show the prevalence rate in Kitgum to be the highest at 4.6% whereas the disease associated with severe liver damage is lowest in South Western Uganda at 0.8%.  

In this year-long study that ended in September 2021, researchers also found females to be the most affected contradicting earlier data that shows hepatitis B to be a largely male disease and also that there is a link between the transmission of HIV and the disease.

Kafeero says they instead found more hepatitis B in areas where HIV was low.  

//Cue in: “We have more HIV ……….          

Cue out: ………….. the virus itself,”//  

Dr. Betty Apica, a herpetologist told URN earlier that she is seeing a lot of young people presenting with liver cancer inwards where the majority succumb to the infection. She says 80% of these are affected by hepatitis B infection. Other than advancing tailored treatment, experts are advocating for the introduction of the Hep B jab at birth.

Apica for instance says less than 30% of the babies that get infected at birth acquire immunity against the disease to not require treatment or progress into liver cancer compared to their adult counterparts. Data shows that 90% of those that get infected in adulthood will shed off infection without using any antiviral treatment.      

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