Hepatitis B is one of those health conditions many Nigerians have heard about but do not necessarily understand. Someone tests positive, and suddenly the room becomes quiet.

Questions start flying around.

Sometimes, the diagnosis itself is not the only problem. What people think the diagnosis means can be just as frightening. Hepatitis B is a viral infection that affects the liver. It can be short-term, known as acute hepatitis B, or long-term, known as chronic hepatitis B. When chronic infection is not properly managed, it can lead to serious liver damage, including cirrhosis and liver cancer.

And Nigeria carries a significant burden.

World Health Organisation estimates that about 14.4 million Nigerians were living with hepatitis B in 2022, but only about 0.6 percent of people with the infection had been diagnosed. That means there is a lot we still do not know about the people living with it. And there is a lot Nigerians still get wrong.

Hepatitis B is not HIV, and the difference matters 

The two are different viral infections.

Having hepatitis B does not mean someone has HIV, and a hepatitis B diagnosis is not proof of someone’s sexual behaviour.

Hepatitis B can be transmitted through infected blood and certain body fluids. In countries where the infection is common, transmission from mother to child around birth and transmission during early childhood are particularly important routes. It can also spread through sex, contaminated needles and other exposure to infected blood or sharp instruments.

So reducing every hepatitis B diagnosis to “you must have had unprotected sex” is not only inaccurate. It can also make people afraid to talk about their health.

Feeling healthy does not mean you are negative

Hepatitis B is not spread through ordinary social contact such as hugging, coughing, sneezing, sharing food or sharing utensils. The concern should be about actual routes of transmission, not treating an infected person as though they are dangerous to be around.

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Many people with hepatitis B have no symptoms, especially when they are newly infected. Someone can look completely healthy and still have the virus.

When symptoms do occur, they can include tiredness, nausea, vomiting, abdominal pain, dark urine and yellowing of the skin or eyes. But waiting for yellow eyes before getting tested is not a reliable strategy. A blood test is how you know your status.

Hepatitis B does not mean the worst, and it is not always about sex 

This is where fear can do real damage. Chronic hepatitis B can cause serious complications, including cirrhosis and liver cancer. But a positive test does not automatically mean that someone is going to develop either condition.

People with chronic hepatitis B can be medically assessed and monitored, and antiviral treatment is available for people who meet treatment criteria. WHO’s 2024 guidelines also expanded and simplified eligibility for treatment.

In other words, a positive result should lead to medical care, not hopelessness.

In highly endemic areas, hepatitis B is commonly transmitted from an infected mother to her baby during birth or between young children. It can also spread through exposure to infected blood, unsafe injections, contaminated sharp instruments and other body fluids.

This matters because blaming someone’s diagnosis entirely on their sexual history can make people miss the bigger public-health conversation: vaccination, safe medical practices, testing and prevention.

Hepatitis B prevention does not end in childhood

WHO describes the hepatitis B vaccine as safe and effective, and vaccination soon after birth is particularly important for preventing mother-to-child transmission.

Adults who have not been vaccinated should also speak with a healthcare professional about vaccination. And when one person tests positive, the answer should not be family panic. Close contacts can be appropriately tested, and people who are not infected and are susceptible can be vaccinated.

Stop treating Hepatitis B like something you can figure out yourself 

Self-treating a serious liver infection with whatever someone recommends at the chemist, church, WhatsApp group or family meeting.

Hepatitis B needs proper testing and medical assessment. People are living with chronic hepatitis B who need regular monitoring. Some need antiviral treatment; others may not need medication immediately. What matters is knowing which situation applies to you rather than guessing.

Hepatitis B is serious.

For a country with millions of people living with the infection and very low diagnosis rates, the more useful questions are not “Who gave you hepatitis B?” or “Does this mean you will die?”

They are much simpler: Have you been tested? Are you vaccinated?

And if you test positive, have you spoken to a healthcare professional about what happens next?

Because sometimes, knowing the truth about a disease is the first step towards taking away its power.

Meiza Nigeria