Thanks for the responses ! For those interested here is a little more information.


There should not necessarily, in my opinion, be a stigma or shame attached to a diagnosis of hepatitis ; HIV/AIDS ; TB, or other illness in which the frequency varies in different parts of the world.


HIV/AIDS is thankfully uncommon in the Philippines and UK, compared to sub-Saharan Africa – and is by no means confined to homosexual males.


Poor health and living conditions increase the risk of TB – while healthy people are at far less risk.


The variation in frequency of Hepatitis B is because causal factors vary in importance. All three are underdiagnosed.


Baruch Blumberg was fascinated by inherited variations in illnesses, and collected thousands of blood samples from around the world. While investigating " yellow jaundice " he discovered a protein in the blood of an Australian aborigine. He called it " Australia antigen " – and later realised this was the surface antigen ( immune response trigger ) for Hepatitis B. We owe him a huge debt of gratitude for work which resulted in the first ever " cancer vaccine " – preventing not only liver cancer, but also the more common hepatitis, resulting from HB infection. By coincidence Australia now has a strict immigrant screening programme.


" Outbreaks " of hepatitis – as described by Rayna, with sensible precautions taken by her Dad – are due to the A ( or E ) virus. This is more likely with poor food hygiene, sanitation, and sewage disposal. After 2-6 weeks it usually presents with flu-like symptoms and jaundice, but most people soon fully recover. The HA vaccine may be given in two doses, with a further booster dose 20 years later if necessary.


HBV takes 2-6 months to incubate and it is often not diagnosed because symptoms may not appear, if at all, for years. Only a small proportion develop chronic hepatitis ; perhaps a fifth of these develop cirrhosis ( liver scarring ) ; and only a tenth of those, cancer. Blood tests can diagnose HBV, and also liver function ( if abnormal, a biopsy is taken for diagnosis by microscopy ).


There are other causes of hepatitis – said to be chronic if lasting over 6 months, diagnosed by blood tests / liver biopsies. Alcohol is a commoner cause in the UK ( and there is also “ non-alcoholic “ hepatitis which may be related to obesity ). Only some of these go on to cirrhosis and cancer. By far the commonest cause of liver cancer in the UK is spread from elsewhere, such as lung.



The HBV vaccine is the solution for prevention of HBV and its consequences. Treatment is very expensive and not curative. The only other “ cancer vaccine “ is for human papilloma virus ( HPV ) affecting cervix ( and other ) sites.


Hepatitis C virus / HCV is another topic; there’s no vaccine ; treatment is also expensive.


HBV is roughly 30X more infectious than HBC and 100X more infectious than HIV.