“Hepatitis can’t wait,”- India also needs to take a pledge to eliminate hepatitis as a public health threat by 2030
By-Dr. Pavan Hanchanale Consultant Hepatologist, Jupiter Hospital, Pune.
Hepatitis is known as the inflammation of the liver and is progressive. It can lead to liver fibrosis, liver failure, cirrhosis and even liver cancer. Given the rising cases globally, Hepatitis has emerged as a disease concern. Hepatitis viruses have been categorized as A, B, C, D and E. Some of the hepatitis viruses are transmitted through contact with unsafe injection practices, blood or other body fluids of an infected person, drug use and sexual contact with an infected person.
As the theme of this year on World Hepatitis Day was “Hepatitis can’t wait,” India also needs to pay serious attention to a commitment and pledge to eliminate hepatitis as a public health threat by 2030. Given the rising disease burden in India, the country cannot wait long to put a robust population health management program to combat the life-threatening disease of viral hepatitis. Moreover, the world is facing an unprecedented health crisis due to COVID-19 and during the pandemic, it is even more important to focus on prevention from Hepatitis. It is clinically evident that the patient with chronic hepatitis and advanced liver disease are at higher risk for more severe COVID-19 complications.
The Disease Burden: A Worry
According to the World Health Organisation (WHO), there are approximately 240 million chronically infected people. According to the Nation Centre for Disease Control, India has “intermediate to high endemicity” for Hepatitis B surface antigen and an estimated 40 million chronic HBV infected people, constituting approximately 11% of the estimated global burden. Hepatitis is preventable, treatable, and curable. However, the majority of patients are not aware of prevention, testing and availability of advanced treatment.
Awareness is the key. The lack of awareness and treatment lead to progressive liver damage and can cause life-threatening conditions such as fibrosis and liver cancer. India needs to respond to the management of the disease efficiently and a robust system of tracing, testing, and treating the unaware victim referred to as the missing needs to be in place.
Focus on Hepatitis C
We need to focus on Hepatitis C which infects the liver and that leads to dysfunction of the liver. It is one of the most common strains of hepatitis and as per estimates of the Indian Society for Clinical Research (ISCR), it affected over 12 million people in India. It is common in the middle age group from 30-60 years. It is normally is transmitted through exposure to the blood from injections and blood transfusions.
There are new medications which can cure hepatitis C in 95% patient. Early detection is always a challenge as the symptoms sometimes remain silent and unclear. Fatigue, mild fever, muscle pain, loss of appetite, nausea, tiredness, dark urine, light-coloured stool, jaundice, and an ache in the abdomen are also considered common symptoms and these can often confuse us with flu.
Diagnosis and Treatment
In absence of timely diagnosis and treatment, Hepatitis can be fatal and life-threatening. First of all, we proceed with blood tests to check liver enzymes, viral antibodies, and viral genetic components. Secondly, ultrasound is used to detect gallstones or cancer and then a liver biopsy is done to assess the damage to the liver. It can be both acute and chronic. In case of acute hepatitis, doctors normally advise rest and consumption of plenty of liquids. But in the case of chronic hepatitis virus, medications are the best option to eliminate the virus
As a preventive measure, one should go for vaccination against hepatitis A and B at the earliest. Unfortunately, there is no vaccination for the most common Hepatitis C. Vaccine for hepatitis E will come in use very soon. To protect and combat hepatitis, it is important to maintain a healthy lifestyle with regular exercise. For a healthy liver, one should say no to alcohol and tobacco. ‘Hepatitis cannot wait,’ hence those who have been drinking and smoking for long should not wait further to quit. Additionally, we need to focus on hygiene also. Washing hands frequently and use of sanitisers can also protect from hepatitis.