By: Dr SanjivSaigal
Worldwide, 296 million people are
living with Hepatitis B while 58 million people are living with hepatitis C.
India has approximately 40 million chronically infected individuals with
hepatitis B, constituting 3-4% of population prevalence. The population
prevalence of Hepatitis C in India is approximately 1%.
Common causes of hepatitis
Viral hepatitis caused due to
hepatitis B and C are among the most common causes of hepatitis. Other
important causes of hepatitis include Alcohol & Non-Alcoholic fatty Liver
disease. Drug induced hepatitis is also an important cause of hepatitis in
India.
Mode of spread of hepatitis B and
C
Hepatitis B is spread when blood,
semen, or other body fluids from a person infected with the virus enters the
body of someone who is not infected. This can happen through sexual contact;
sharing needles, syringes, or other drug-injection equipment, or from mother to
baby at birth. Hepatitis B and Hepatitis C have similar modes of transmission.
Early and late symptoms of
hepatitis
Not all people with acute HBV
infection have symptoms. Most children <5 years of age and newly infected
immunosuppressed adults are generally asymptomatic, whereas 30%–50% of people
age ≥5 years have signs and symptoms. When present, signs and symptoms of acute
HBV infections can include fever, fatigue, loss of appetite, nausea, vomiting,
abdominal pain, dark urine, clay-colored stool, joint pain and jaundice. Some
patients of chronic hepatitis B can develop cirrhosis or hepatocellular
carcinoma over long term.
Similarly, the majority of newly
infected persons with hepatitis C may remain asymptomatic. Many people
eventually develop chronic liver disease after several years, which can range
from mild to severe and include cirrhosis (scarring of the liver) and liver
cancer.
Diagnosis of Hepatitis B and C
There are some blood tests which
can easily detect hepatitis B and hepatitis C infection. These basic screening
test are HbsAg and Anti-HCV .Among those who are infected, viral load testing
is done to assess the magnitude of infection. Some patients will need further
testing such as Ultrasound, Fibroscan, CT scan or MRI and Endoscopy to further
evaluate the magnitude of liver disease.
Treatment of Hepatitis B and C
People with acute hepatitis B
infection are provided supportive treatment depending on their symptoms. For
people with chronic infection, several highly effective antiviral medications
are available (such as Entecavir&Tenofovir).
Treatment for Hepatitis C is
recommended for all people with detectable HCV RNA. Currently available
antiviral drugs for hepatitis C are highly effective with a cure rate of over
95%
Preventive measures
For prevention of viral hepatitis
it is important to avoid coming in contact with blood or bodily fluids of
others which can be done by avoiding sharing personal items, such as razors or
tooth brushes, not sharing drug needles or other drug equipment. One must be
careful when getting tattoos and body piercings & ensuring safe sexual
practices. Highly effective vaccine is available for Hepatitis B and all
infants should be vaccinated for Hepatitis B. Vaccine for Hepatitis C is not
yet available. Awareness about Hepatitis B and C should be our topmost
priority.
The writer is Principal Director and Head, Hepatology and Liver Transplant Medicine, Max Hospital Saket, New Delhi
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