Hepatitis patients battle stigma, cost, late diagnosis

By Seun Adeuyi (Abuja), Hope Abah (Makurdi) & Hassan Ibrahim (Bauchi)   Viral hepatitis remains one of Nigeria’s most neglected public health challenges despite the availability of vaccines, effective treatment and growing awareness campaigns aimed at eliminating the disease. Health experts say millions of Nigerians are living with chronic Hepatitis B and C infections, many […]

By Seun Adeuyi (Abuja), Hope Abah (Makurdi) & Hassan Ibrahim (Bauchi)

 

Viral hepatitis remains one of Nigeria’s most neglected public health challenges despite the availability of vaccines, effective treatment and growing awareness campaigns aimed at eliminating the disease.

Health experts say millions of Nigerians are living with chronic Hepatitis B and C infections, many without knowing it because the diseases often progress silently for years before symptoms emerge. By the time many patients seek medical attention, they have already developed serious complications such as liver cirrhosis, liver failure or liver cancer.

As Nigeria joins the rest of the world today to commemorate this year’s World Hepatitis Day with the theme, “Hepatitis: Let’s Break It Down,” stakeholders are calling for renewed efforts to dismantle the barriers preventing people from accessing testing, treatment and lifesaving information.

The campaign seeks to tackle stigma, misinformation and financial obstacles while encouraging governments to strengthen hepatitis prevention, early diagnosis and access to care.

According to the World Health Organisation (WHO), hepatitis B and C collectively claim more than one million lives every year, largely through liver cirrhosis and liver cancer. Yet experts maintain that both diseases can either be prevented or effectively managed, while Hepatitis C can now be cured with modern medicines.

One of the greatest concerns, medical experts say, is that infected persons often remain symptom-free for years. When symptoms eventually appear, including persistent fatigue, fever, nausea, abdominal pain, jaundice, dark urine and unexplained weight loss, the liver may already have suffered significant damage.

For many Nigerians, discovering they have hepatitis comes unexpectedly.

For years, Victoria Joseph had no idea she was living with Hepatitis B. It was only while preparing to give birth to her second child in October last year that routine hospital tests revealed the infection.

Like thousands of Nigerians, she had continued with her daily life without symptoms, unaware that the virus was silently attacking her liver.

Doctors immediately commenced treatment, giving her hope that the disease could be controlled.

“The last time I was told it was almost cleared. We bought the initial drugs for N18,000, but the treatment is now generally subsidised at the government hospital where I receive care,” she said.

Despite the encouraging progress, Victoria admitted that staying on treatment has not been easy because of the financial demands and the lifelong commitment required to manage the disease.

Her husband, Joseph, said the diagnosis changed the family’s attitude towards preventive healthcare.

He subsequently tested negative before receiving the Hepatitis B vaccine in January.

“I had to undergo a test before taking the vaccine, which is expected to protect me for about 10 years,” he said, adding that he would ensure his wife completes her treatment.

 

The price of late diagnosis

Victoria’s experience reflects a pattern that doctors say is common across the country.

For Monica Joji, the consequences of late diagnosis proved devastating.

More than five years after losing her husband to hepatitis-related complications, she still recalls how the disease went undetected until it had severely damaged his liver.

“The virus had dealt a serious blow to my husband’s liver before we knew it. He was always receiving treatment for what doctors thought was another illness until further tests confirmed he was Hepatitis B positive.

“He battled the illness for several months in the hospital before he eventually died. We spent so much money, but it was all to no avail. I later tested negative and got vaccinated,” she said.

Medical experts say stories like Monica’s illustrate one of the biggest challenges in the fight against hepatitis – late diagnosis.

Because the disease progresses silently, many patients only discover they are infected after developing liver cirrhosis, liver failure or liver cancer, significantly reducing their chances of successful treatment.

 

High treatment costs, limited access

For Aisha Ismail from Takum in Taraba State, the challenge has not been discovering the disease but accessing specialist treatment.

Already living with chronic Hepatitis B, she was referred to the Abubakar Tafawa Balewa University Teaching Hospital (ATBU-TH), Bauchi.

Instead of receiving immediate treatment, she spent more than four weeks moving from one hospital department to another for laboratory investigations and consultations before eventually seeing a consultant.

“I spent over N300,000 on medications before I was referred to Bauchi. The biggest challenge has been the numerous tests and the high cost of treatment,” she said.

Being unfamiliar with Bauchi compounded her ordeal.

“I didn’t know anyone in Bauchi. I had difficulties processing appointments and on two occasions I couldn’t even secure bookings.”

Her situation only improved after another patient offered her accommodation and assisted her in navigating the hospital procedures.

However, another challenge soon emerged.

She was referred to Gombe for a CT scan after discovering that the equipment required for the investigation was unavailable in Bauchi.

“I was told the scan would cost N30,000 but I was charged N60,000. Transportation cost another N15,000. I had to remain in Gombe for three days before collecting the results.”

Months after arriving for treatment, she was still undergoing investigations before doctors could begin definitive therapy.

She appealed to both the federal and state governments to subsidise hepatitis treatment and improve diagnostic facilities.

“Patients should not have to travel across states because essential machines are unavailable,” she said.

Her experience highlights the broader challenges confronting hepatitis patients, including inadequate diagnostic facilities, limited specialist services and the heavy financial burden associated with treatment.

 

Benue among hotspots

The burden is particularly evident in Benue State.

Available data indicate that the state remains one of Nigeria’s hepatitis hotspots.

Earlier projections based on a population of over four million estimated that more than 586,000 residents were living with Hepatitis B.

Although recent estimates suggest prevalence has declined slightly, from about 14.2 percent among screened individuals in Makurdi to around 12.2 percent statewide, health authorities say the figures remain worrying.

Hepatitis C prevalence has also remained relatively stable at about 2.3 percent.

The Benue State Commissioner for Health and Human Services, Dr Paul Ogwuche, said hepatitis continues to pose a major public health challenge despite the modest improvement.

He said the large number of people living with chronic hepatitis underscores the need for expanded vaccination, routine screening, early diagnosis and improved access to treatment.

“The challenge with hepatitis is that many infected persons have no symptoms for years, yet they remain at risk of developing liver cirrhosis and liver cancer if left undiagnosed and untreated. This is why we continue to emphasise screening and early diagnosis,” he said.

According to him, the state government is strengthening routine childhood immunisation, promoting safe blood transfusion practices, improving infection prevention in health facilities and encouraging safe sexual practices to reduce transmission.

He also urged pregnant women, healthcare workers, blood donors and other high-risk groups to prioritise testing.

 

Experts prescribe way forward

Experts explained that hepatitis is an inflammation of the liver caused by viruses, with Hepatitis B and C posing the greatest public health concern because they often become chronic infections.

The viruses spread through infected blood and body fluids, unsafe injections, contaminated sharp objects, unprotected sexual contact and from infected mothers to their babies during childbirth.

Unlike Hepatitis C, Hepatitis B has an effective vaccine, making prevention one of the strongest weapons against the disease.

A Chief Consultant Physician and Gastroenterologist at ATBU-TH, Associate Professor Mustapha Sabon Umar, said Nigeria remains among countries with a high hepatitis burden.

He estimated that between nine and 11 percent of Nigerians are living with chronic Hepatitis B, with parts of the North-East recording even higher prevalence.

According to him, routine testing remains the only reliable way for people to know their status.

“We need to promote routine Hepatitis B testing, especially during antenatal care because one major route of transmission is from mother to child.

“If pregnant women are tested early enough, treatment can reduce the risk of passing the virus to their babies.”

He also expressed concern that many newborns still miss the crucial Hepatitis B birth-dose vaccine, which should ideally be administered within the first 24 hours after birth.

Umar called for hepatitis services to be integrated into universal health coverage to reduce catastrophic out-of-pocket expenses, while advocating sustained funding, decentralised services and stronger data collection to guide interventions.

For patients already diagnosed, he said the outlook is encouraging if treatment begins early.

While chronic Hepatitis B can be controlled with long-term antiviral therapy, Hepatitis C is now curable in most patients using direct-acting antiviral drugs.

Doctors also advise patients to avoid alcohol, maintain healthy diets, exercise regularly, keep follow-up appointments and never discontinue medication without medical advice.

For families like Victoria’s, Monica’s and Aisha’s, however, the battle extends beyond medicine.

It is also about making diagnosis affordable, specialist care accessible and ensuring that no Nigerian discovers the disease only after irreversible liver damage has occurred or loses a loved one because hepatitis was mistaken for another illness.