World Hepatitis Day

Every year the 28th of July is observed as World Hepatitis Day. It is one of the few global public health days declared by the WHO to spread awareness of a silent, long term killer viral disease with worldwide distribution.

What is hepatitis ?

The condition in which the liver gets injured due to any agent or disease is called hepatitis. Of the viruses that cause hepatitis the ones of special mention are Hepatitis A, B, C, D and E. While Hepatitis A and E are limited to causing acute infection, Hepatitis subtypes B, C and D can cause chronic hepatitis in almost similar fashion that can damage the liver permanently. More attention is given to Hepatitis B and C as Hepatitis D is a satellite virus which cannot replicate in the absence of hepatitis B virus.

Why should we bother?

It is a common problem : In the world about 350 million people live with chronic viral hepatitis. India being the most populous nation in the world bears a huge brunt of the disease. India is thought to have around 40 million Hepatitis B and around 9 million Hepatitis C patients based on estimates a few years ago.
It is a deadly problem :While 8000 new viral hepatitis B or C occur everyday around 3000 are estimated to die every day. It is estimated that around 1.8 lakh patients die of hepatitis B and C combined in India.
It is silent. Only around 10% of the total infections come to light. 90 percent do not know that they have the disease. Of those infected with chronic hepatitis B or C, only in the last stage when the liver gets permanently damaged over many years do patients get symptomatic.
It affects a vital organ: The liver is the main organ affected in chronic hepatitis B or C. As we all know the liver is essential for life and no machine can replace its function unlike the case in kidney failures where dialysis can be done. The theme of this year’s world hepatitis day observed by WHO is One Life One Liver. We have only one liver and one life, Chronic Viral hepatitis can devastate both.
It is preventable : While chronic viral hepatitis can devastate the liver and lead to so many deaths, it is a preventable disease. And we all know that prevention is better than cure. In several countries testing for hepatitis is offered to any adult but government policies may differ. In India the focus is on educating the at-risk population, testing pregnant women to prevent spread to babies, safe blood transfusion, disposable needle usage, vaccination of all infants at birth etc.

How do these viruses get into our body?

The viruses do not get transmitted by touch, hug, cough, sneeze , water, food etc but mainly by exposure of vulnerable areas to infected body fluids like blood. Hence transmission can be seen during birth from infected mother to baby, blood product transfusion, contaminated syringes, needles, blades etc apart from sexual activity especially unprotected intercourse with multiple sexual partners. As the viruses can stay infectious outside the body for a few days, for example on the surface of needles and blades, transmission during tattooing, hair cuts, shaving, tonsuring etc also assume importance.

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What happens after hepatitis B or C enters the body?

Generally the body mounts an inflammatory response against the viruses. It differs between the Hepatitis virus subtypes.
While 95 % of the adults who get hepatitis B clear the virus in a few weeks or months, around 5% enter into chronic stage. The situation is reversed in infancy and early childhood and hence there is a huge focus on vaccination in infancy.
Around 70% of hepatitis C infections get cleared from the body but about 30 % develop chronic hepatitis.
In the stage of chronic hepatitis, the liver gets damaged slowly over many years mainly without symptoms and the damage being initially diagnosed in blood reports and scan reports.
Of those with chronic viral hepatitis due to B or C around 20 – 40 % develop liver cirrhosis (permanent damage of liver) or liver cancer.

How is it evaluated by the doctor?

As it is a silent disease, mainly patients with chronic stage are monitored periodically for

Appearance of symptoms : After many years of chronic viral hepatitis, symptoms of liver damage like jaundice (yellow urine, yellow eyes), protruding abdomen due to fluid accumulation, swelling in legs, fatigue, malnutrition, weight loss, blood vomiting etc. At Progress Gastro Care, our team of experienced doctors and state-of-the-art facilities are dedicated to providing the highest quality care and best liver treatment in Chennai.
Changes in physical examination : These happen after a few decades of chronic viral hepatitis in the form of jaundice , ascites, dilated veins on abdomen, hernias of abdominal wall, weight loss, hair loss, dry shiny skin etc.
Lab tests including Liver function tests, tumor markers in blood for screening of cancer and viral activity by various tests including estimation of number of viral particles in blood. With a team of expert medical professionals and state-of-the-art facilities, Progress Gastro Care, liver inflammation treatment in Chennai, is committed to improving the lives of individuals suffering from liver diseases.
Ultrasound and other imaging studies : While ultrasound studies the morphology of liver including its size smoothness of liver surface, fluid in abdomen etc, , Doppler ultrasound gives information of blood flow to liver ; fibroscan can indirectly predict liver cirrhosis early by assessing liver stiffness; a CT scan or MRI scan may give additional information on liver condition and cancers. Our team of highly skilled doctors and staff are dedicated to providing personalized care and innovative liver treatment in Chennai.
Monitoring of other aspects : As these patients regularly visit gastroenterologists over the years, special care is given to prevent other factors that can affect the liver like avoiding alcohol, reducing fat and carbohydrate consumption , maintaining appropriate weight and healthy lifestyle. Over the long term the general health and other organs that can be potentially affected by these viruses are also monitored. Counselling and support are mandatory. Progress Gastro Care offers state-of-the-art treatment options for liver failure treatment in Chennai, backed by years of experience and expertise.

What treatments are available?

Treatment in the form of tablets and injections are available. But hepatitis b treatment is necessary only when liver damage is evident in various tests to prevent further damage. Nowadays more than 90 percent of hepatitis C can be cured in a few months with medicines. While there is a very effective vaccine for Hepatitis B there is none for hepatitis C.

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What action can I take today on account of the awareness I have received ?

Encourage vaccination for hepatitis B in your family and community. Still around one third of newborns in the country miss Hepatitis B vaccine.
Encourage those known to you with hepatitis B or C to get treated and monitored. Only 15-30 % with diagnosed hepatitis B or C are on treatment. It is easy to take as tablets and also available free of cost at government centres.
Follow safe sex practices to avoid exposure to infected body fluids knowing that nothing should be considered fool proof
Take special care at tattooing , at saloons, at tonsuring etc to insist on clean use and disposable sharp items
Talk about this topic in your circle to provide awareness. You could indirectly save lives.

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