We often see patients at our hospital who are surprised at the diagnosis of Hepatitis B. Often they feel completely well. They came in for a routine check before a visa medical, before starting a new job, or because a relative was recently diagnosed and the family wanted everyone screened. That surprise is the reason we mark World Hepatitis Day: this is a disease that rarely announces itself, yet it quietly affects millions of people across East Africa, many of whom will never know they are carrying it until real damage has already begun. Uganda has a high burden of Hepatitis B Virus (HBV), with an estimated national prevalence of 4.1% to 4.3%. Let us understand the common symptoms, preventive measures, and treatment options for Hepatis B.
What is Hepatitis B?
Hepatitis B is an infection of the liver caused by the Hepatitis B virus, spread through infected blood and certain body fluids such as semen and vaginal secretions. Once the virus enters the body it travels to the liver and infects the cells there. It doesn't announce itself right away - it can take anywhere from thirty to a hundred and eighty days before any sign appears, and for a good number of patients, no sign ever does. What actually causes the damage is not the virus alone but the body's own response to it: immune cells try to clear the infected liver cells, and in doing so they cause the inflammation we see on blood tests and, over time, on scans.
Types of Hepatitis B
These are the most common forms of Hepatitis B seen:
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Acute Hepatitis B
A short-term infection where the HBsAg marker is present for less than six months. Most healthy adults and children over five clear it naturally within a few weeks to six months, though the liver can show real inflammation and cell damage while this is happening. -
Chronic Hepatitis B
An infection where the HBsAg marker persists beyond six months. This is far more likely in infants and young children - up to ninety percent of infants and a quarter to half of young children infected go on to develop chronic disease, compared to about five percent of adults. Left unchecked over the years, it can progress to liver scarring, cirrhosis, and liver cancer.
Causes of Hepatitis B
- Unprotected sexual contact - vaginal, oral, or anal - with an infected person
- Direct contact with infected blood, semen, or vaginal secretions
- Sharing needles, syringes, or sharp instruments used for drugs, tattooing, or piercing
- Needle-stick injuries or accidental exposure to infected blood
- Unsafe medical procedures - injections, surgery, or transfusion - where infection control is not properly followed
- Mother-to-child transmission during birth
It's worth being clear about what does not spread Hepatitis B, because I get asked this often: sharing a meal, hugging, kissing, coughing, sneezing, or breastfeeding a vaccinated infant with intact skin does not pass the virus on.
Common Symptoms of Hepatitis B
- Persistent tiredness or weakness
- Fever or a general feeling of being unwell
- Joint pain or swelling
- Pain or discomfort in the upper abdomen
- Loss of appetite
- Nausea and vomiting
- Dark urine or pale stools
- Yellowing of the skin or eyes - jaundice
Many patients have none of these hepatitis B symptoms, particularly early on, which is exactly why doctors recommend testing rather than waiting for the body to give a clear signal.
Risk Factors of Hepatitis B
- Unprotected sex or multiple sexual partners
- Injecting drug use or sharing needles
- Being born to a mother with Hepatitis B
- Living with someone who has Hepatitis B, especially with shared exposure to blood or body fluids
- Not being vaccinated
- Living or having been born in a region where Hepatitis B is common, including much of East Africa
- Having HIV or Hepatitis C alongside Hepatitis B
- Occupational exposure to blood or needles, such as in healthcare work
- Being on long-term kidney dialysis
- Living or working in crowded settings where exposure risk is higher
Preventive Measures for Hepatitis B
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Vaccination
The single most effective protection we have, given in a two-, three-, or four-dose schedule depending on age. For newborns of infected mothers, the vaccine - sometimes with an added antibody injection called HBIG - should ideally be given within twelve hours of birth. -
Antenatal screening
Every pregnant woman coming through our hospital is offered testing, so that if she is positive, we can protect her baby from the moment of delivery. -
Safer sex practices
Condom use meaningfully reduces transmission risk. -
Avoiding shared sharp items
Needles, razors, and toothbrushes should never be shared, and tattoo or piercing tools should always be properly sterilized. -
Prompt post-exposure care
If you've had a possible exposure, come in as soon as possible - ideally within twenty-four hours - since post-exposure protection becomes far less effective the longer it is delayed. -
Pre-travel vaccination check
Anyone travelling to or relocating within higher-prevalence areas should confirm their vaccination status beforehand.
Hepatitis B prevention is a crucial part of healthcare and goes a long way in protecting your liver health.
How is Hepatitis B Treated?
Hepatitis B treatment depends on whether the infection is acute or chronic, and how the liver is coping.
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Acute infection
Most healthy adults recover on their own and need no antiviral medicine at all. We focus on rest, good hydration, a balanced diet, and avoiding alcohol or anything else hard on the liver. Severe cases with signs of real liver strain may need hospital monitoring and, occasionally, antivirals such as tenofovir or entecavir. -
Chronic infection
Not every patient needs to start treatment immediately - many are simply monitored with repeat blood work and imaging every six to twelve months. When treatment is indicated, long-term antivirals such as tenofovir, entecavir, or lamivudine, and occasionally interferon, help bring the virus under control, protect the liver, and lower the risk of cirrhosis or liver cancer, even though they rarely clear the infection completely.
Hepatitis B Care at UMC Victoria Hospitals
At UMC Victoria Hospitals in Kampala, Hepatitis B screening is part of routine antenatal care, and the vaccine - including the birth dose - is available for newborns, unvaccinated adults, and anyone preparing to travel. If you test positive, we don't just hand you a result; we walk you through what it means. We arrange the right follow-up tests, and set a monitoring plan or hepatitis B treatment in Uganda suited to your situation.
Because chronic Hepatitis B often runs in families, we also encourage family-wide screening once one member tests positive, so we can protect those who are still negative and start care early for anyone who isn't. This World Hepatitis Day, if you've never checked your status, or if you're pregnant, planning a pregnancy, or living with someone who has Hepatitis B, come in and get tested. It's a small step, and it can protect your liver - and your family - for years to come.
