This is a mail I received from a reader trying to find out the available hepatitis b drugs in Nigeria a week ago and it is copied verbatim with his permission
“Goodafternoon my Doctor, i need your help and medical input on my predicament, I went for hepatitis b screening test in one of the diagnostic centres in Lagos and test results came out positive. Shocked and in total denial since i had no symptoms whatsoever, i rejected the results. The doctor in the centre told me to carryout the test 3 months later and in another laboratory. On my field trip to Abuja, i used the opportunity to repeat the test and results were the same(still positive). Convinced with the results now, I paid a visit to a gastroenterologist in Lagos University Teaching Hospital (LUTH), she examined me, carried out other series of tests she called the liver function test(ALT and AST) which she said was elevated and instructed me to start treatment and she prescribed interferon for me that I am to take for 48 weeks. Now my problem, interferon as one of the medicine for hepatitis b in Nigeria is very scarce and expensive. I was told it is only available in Lagos and Abuja. A pharmacy store in Lagos told me that a dose costs #30,000 naira per week, meaning i will spend up to 2million naira to get cured of hepatitis b (since I will be taking the the drug for one year) which in all honesty I cannot afford. Please doctor, what are the other available hepatitis b drugs in Nigeria? Where can I get them? What is the cost of hepatitis b drugs and treatment in Nigeria? Are there other centres for hepatitis b treatment in Nigeria apart from LUTH? When can I start treatment for hepatitis b since I don’t have any symptoms? Thank you for your anticipated reply – ganiyu from Lagos.”
Thank you for choosing to share your hepatitis b story with the public. This is the same treatment problems many Nigerians diagnosed of hepatitis b virus infection face and they don’t know how to go about it. They have difficulty finding where and how to get hepatitis b drugs in Nigeria, the drugs are scarce, and even when available they are always very expensive as the treatment of hepatitis b is not subsidized in Nigeria. It is important for you to know that hepatitis b drugs in Nigeria are not the the everyday drugs patients buy over the counter so very few pharmacy stores stock them. Sometimes they suffer losses when the drugs expire.
Hepatitis b drugs in Nigeria
Right now, about 6 medicines are approved for the treatment of hepatitis b in Nigeria by the National Agency for Food and Drug Administration and Control (NAFDAC). They are:
1. Tenofovir (viread)
Trade name is Viread and it is in tablets. It is good for persons with chronic hepatitis b infection. Tenofovir does not cure hepatitis b but lowers the amount of the virus in your body by suppressing their ability to multiply. It can be taken alone and try not to miss any pill to avoid resistance. Take one tablet per day.
Your doctor will advice you to do regular blood tests to monitor you liver enzymes (ALT & AST). Lowering of your liver enzymes signifies improvement.
It is available in designated pharmacy shops in Lagos, Abuja, Benin, Anambra, and Port Harcourt.
Cost: A bottle of tenofovir contains 30 tablets which costs between #7,000- #9,000 naira
2. Lamivudine (epivir, zeffix)
The most widely used antiviral drug for hepatitis in Nigeria and it comes in 150mg, 300mg tablets and 10mg/ml syrup. It is used for both HIV and Hepatitis B patients. It does not cure but suppresses the multiplication of the hepatitis b virus to undetectable levels so that the liver can heal on its own. Routine blood tests are advised to assess the liver and kidney functions. A tablet (150mg) is taken once a day and for an unstipulated duration (may be lifelong). Its major problem is resistance. Patients that discontinued lamivudine have been shown to suffer relapses.
It is available in designated pharmacy stores in Lagos, Abuja, Benin, Port Harcourt and some other parts of Nigeria. In Lagos you can get Lamivudine @ Alpha Pharmacy, Ikeja.
Price of lamivudine in Nigeria: A bottle of lamivudine costs #8,000-#9,000 naira.
It comes in tablets( 0.5mg and 1mg) that is taken once daily. Effective against the multiplication of hepatitis b. It is best taken on empty stomach( 2hours before meal). Can be used for both adults and children.
Available in designated pharmacy stores in Lagos, Abuja, Port Harcourt, Ibadan, and Kano.
Price of Entecavir in Nigeria: I put a call through to to Alpha Pharmacy in Ikeja, Lagos and the pharmacist there told me that 0.5mg of entecavir (containing 10 tablets) costs #17,000 naira and 1mg of entecavir (containing 10 tablets) costs #20,000 naira.
4. Telbivudine (Tyzeka, sebivo)
Comes in tablets (600mg). It is a pill taken once a day for at least one year or longer. It was approved in 2006 for adults. Like other drugs, it slows down the multiplication of hepatitis b virus but does not cure or prevent the transmission of the virus. Patients that stop the drug abruptly suffers relapse so let you doctor know before stopping the medication. Tebivudine is available in Alpha Pharmacy, Ikeja, Lagos.
The cost of tebivudine for a year is about #750,000 naira.
5. Adefovir dipivoxil (Hepsera)
Comes as 10mg tablet (a satchet contains 30 tablets). To be daily once daily for up to 1 year or more. Not recommended for children. Patients on Adefovir are instructed to do routine liver and kidney function tests.
The cost of treating hepatitis b with adefovir for a year is around #500,000 naira.
Interferon is the most expensive of the drugs for hepatitis b in Nigeria. Very effective against hepatitis b infection and the only hepatitis b drugs not given orally but with injection. It is given once a week for about 48weeks to 52 weeks (a year). Interferon is available in Nigeria at Alpha Pharmacy, Lagos.
A dose of interferon cost about #25,000- #30,000 naira a week. Treatment of hepatitis b with interferon will cost about N1.5- N2 million naira a year.
When can you start treatment for hepatitis b?
It is not everyone with the hepatitis b virus that require treatment. Certain conditions have to be met and confirmed through some lab tests. Your HBV-DNA (hepatitis B viral load) have to be assessed. Hepatitis b viral load indicates the viral burden and viral multiplication. It is used to assess recovery from infection and candidacy for treatment. It has a reference range that varies from lab to lab. Going above the specified reference range make you a candidate for treatment.
In Nigeria, Hepatitis B viral load can be done in Lagos, Abuja, Benin, Ibadan, Enugu and many other teaching, state hospitals and private labs. In Lagos, hepatitis B viral load can be done at LUTH, LASUTH, Nigerian Institute of Medical Research(NIMR) in Yaba for around #30,000- #50,000 naira. In Abuja you can do the test at National Hospital around the same price.
Hepatitis b treatment centres in Nigeria
Apart from the Lagos University Teaching Hospital, your hepatitis b infection can be effectively managed in the following centres in Nigeria.
- University of Benin Teaching Hospital, Edo State
- Irrua Specialist Hospital, Irrua, Edo
- National Hospital, Abuja
- Lagos State University Teaching Hospital, Lagos
- Nnamdi Azikiwe Teaching Hospital, Anambra.
- University of Nigeria Teaching Hospital, Enugu
- Federal medical Centre, Lokoja
- Ahmadu Bello Teaching Hospital, Zaria, Kaduna
- Obafemi Awolowo University Teaching, Ife, Osun
- Federal Medical Centre, Ebutte Meta, Lagos
- Federal Medical Centre, Owerri
- Federal Medical Centre, Owo
- Some state and private hospitals
Are there other approved hepatitis b drugs in Nigeria you know? Please share with us.
Caveat: The information contained here is not a substitute to visiting the hospital and seeing a doctor for proper consultation.
Read more about hepatitis from Mayoclinic