Dr Ravi Kiran, Consultant Hepatology, Narayana Health City talks about hepatitis prevention and need of the hour
Hepatitis is major health concern especially in developing and under developed countries. In fact, greater awareness about viral hepatitis is critical to limit the spread and subsequently to eradicate the condition from our country.
Which are the different types and how does one get infected with hepatitis
There are various types of viruses that can cause Hepatitis, important among them being hepatitis virus A, B, C, D and E. These virus have special affinity to infect liver and cause problems ranging from self-limited illness to life threatening condition that require ICU care and liver transplantation. India accounts for around 11% of the global burden of chronic HBV infected people with a population prevalence of 3-4%. There is a wide variation in prevalence of Hepatitis B and Hepatitis C in different geographical regions.
Hepatitis A and E in most cases present in mild form acutely and is often self-limiting. These virus are responsible for several epidemics and Hepatitis outbreaks in our country. Hepatitis A and E are also the important causes for acute liver failure in our country. Up to 0.1% of Hepatitis A and 1-2% of Hepatitis E cases may have a severe disease called fulminant Hepatitis. This condition may be especially severe with Hepatitis E infection during pregnancy. These virus’ spread from contaminated water and stale food. Hence, good hygiene and sanitation goes a long way to prevent the spread of these two viruses. They don’t cause chronic liver disease or liver cancer.
Hepatitis B and Hepatitis C are notorious to cause chronic liver disease and complications there on. Most of the time clinical attention is sought because of an abnormal value in blood test or abdomen scans. Also, people may come to medical attention with advanced liver damage. Virus transmission can occur parenterally, prenatally or sexually. Injection drug users, truckers, attendees of sexually transmitted infections (STI) clinics, people with thalassemia, haemophilia and other diseases requiring repeated blood transfusions have higher prevalence of Hepatitis B and Hepatitis C. Some practices like tattooing, scarification, body piercing can lead to higher rates of HCV transmission. People with high risk behaviour and family members with Hepatitis B must seek medical attention to screen for infection.
People with hepatitis infection still suffer from social stigma and not come forward to and seek medical help. Early detection of the presence of these chronic infections lead to early cure and help in mitigating the further damage to the liver. Inordinate delay in treatment can lead to progressive liver damage causing symptoms like accumulation of fluid in the abdomen, vomiting of blood, encephalopathy or liver cancer. Once the liver disease reaches this stage, showing complications listed above, liver transplantation might be the only option to prolong life.
Prevention and treatment
People can protect themselves from Hepatitis B by getting vaccinated against it. Available vaccines are affordable and have high protective efficacy of more than 95% when administered before exposure. New born babies to HBV infected mothers can be administered vaccine and immunoglobin to prevent transmission. There are no vaccines available to prevent transmission of Hepatitis C. If the infection with Hepatitis B or C is confirmed in an individual, doctors decide on the need and mode of treatment. Unlike in the past, these days treatment of Hepatitis B and C infection is very simplified. Especially for Hepatitis C, treatment is definite.
We should all pledge together to work collectively towards creating awareness about the condition and do our bit towards preventing the spread of the condition.