Every year 28th July is celebrated as World Hepatitis Day by WHO. Today, by means of this blog, we will try to understand the nature of Hepatitis and measures to prevent it.
What is Hepatitis? “Hepat” means liver and “itis” means swelling. Hence, it means swelling of liver. Overall the focus of World Hepatitis Day is towards hepatitis caused by viruses—Viral Hepatitis.
Viral hepatitis B and C affect 325 million people worldwide causing 1.4 million deaths/year. It is the second major killer infectious disease after tuberculosis, and nine times more people are infected with hepatitis than HIV. Hepatitis is preventable, treatable, and in the case of hepatitis C, curable. However, over 80% of people living with hepatitis are lacking prevention, testing and treatment services.
In India, Hepatitis A and Hepatitis E are transmitted due to infected water or food. Usually, these infections are self-limiting but can cause life threatening infections in a few cases. Especially in pregnant women infection with Hepatitis E is very dangerous, hence needs particular attention.
Hepatitis B and C are transmitted in different manner. When already infected mother gives birth to a child the chances of transmission are very high, this means of transmission is known as vertical transmission. On the other hand, by means of unprotected intercourse, infected syringes, infected blood products can also lead to viral spread from one person to another which is known as horizontal transmission. Person with intravenous drug abuse, HIV infections, person on hemo-dialysis and those requiring frequent blood products (thalassemia, haemophilia) are especially at high risk of acquiring infection.
In India, as per latest estimates, 40 million people are chronically infected with hepatitis B and 6 to 12 million people are chronically infected with hepatitis C.
On one hand, Hepatitis A and E causes illness for short duration. In absence of a pre-existing liver disease usually the infection gets cleared without causing permanent damage. In some cases where the disease is very severe, life threatening hepatitis can happen which may need ICU care and liver transplantation.
Hepatitis B and C on other hand has tendency to last for prolonged duration and can cause chronic illnesses. The spectrum of diseases includes chronic hepatitis, cirrhosis of liver and liver cancer (Hepatocellular carcinoma). These virus remains calm in body and only a few symptoms appear till permanent damage to liver-cirrhosis sets in. Once cirrhosis develops multiple symptoms like fatigue, jaundice, swelling in the body, reduced consciousness and vomiting of blood appear on the surface. Therefore, it is essential for us to pick up the infection early and treat it before the development of cirrhosis and liver cancer.
Very efficient treatment is available for Hepatitis B and C. Oral medicines for Hepatitis B is effective in suppressing the virus and keeping the viral load lower down to reduce liver damage. Recent achievements in treatment of Hepatitis C have made it the only curable virus. Oral medications for 3 to 6 months clear the virus for body in almost all cases. A simple card base blood test is sufficient enough to find out presence of B and C viruses, and hence can prevent major morbidities.
So what should be done for prevention of hepatitis?
1. Avoid consuming impure food and water. Especially from the places where hygienic measures are not taken in preparing the food.
2. Say a big “No” to unprotected sex and intravenous drug abuse.
3. Community based periodic checking of Hepatitis B and C can help to pick the cases early and gives opportunity to treat them at an early stage.
4. All pregnant women should be checked for Hepatitis B and C.
5. Vaccines are available for Hepatitis B. Those who are at high risk of acquiring infection like health care workers and close kins of Hepatitis B patients must be offered vaccination.
The theme for 2019 World Hepatitis Day is “invest in eliminating hepatitis”. Let us all invest our precious time and spread this knowledge in community for awareness of Hepatitis, which will help in building a healthy community, healthy city, healthy country and healthy future.
Dr.Vatsal Mehta | Medical Gastroenterologist and Hepatologist | Narayana Multispeciality Hospital, Ahmedabad