World Hepatitis Day 2022: Awareness key to eliminate viral hepatitis from India
Liver diseases and liver cancers are a common cause of death and disability in our country. Nearly a third of all patients with liver cirrhosis, and over half of liver cancers are related to hepatitis B and C. In the current era, both diseases are easily detected and treatable. Unfortunately, they usually go undiagnosed until damage to the liver has already been done. It is deeply disturbing that thousands of deaths could have been prevented by a simple blood test and taking a tablet.
The WHO designated 28th July as World Hepatitis Day to raise awareness about viral hepatitis. 28th July was the birthday of Nobel Laureate Baruch Samuel Blumberg, who discovered the hepatitis B virus. With an aim to achieve hepatitis elimination by 2030, this year’s theme is – “I Can’t Wait”. The theme could not be more apt. As a liver specialist dealing with potentially preventable deaths and suffering every day, I can’t wait for viral hepatitis to be eliminated from India. My focus in this article would be Hepatitis B and C- viruses which cause chronic liver disease, cirrhosis, and liver cancer.
How are these infections acquired?
Hepatitis B and C are both transmitted through bodily fluids. So, contact with contaminated blood products, unsafe injections and unsafe sexual practices are common modes of transmission. In case of hepatitis B, mother to child transmission through womb is the most common cause. The incorporation of precautions like proper screening of blood products at blood banks and screening of all women during pregnancy has already massively curtailed transmission of viral hepatitis. Moreover, the incorporation of hepatitis B immunization into the national immunization schedule would go a long way in preventing future development of hepatitis B in the community.
Unsafe injections are still a major health hazard in our country, especially in rural and semi-urban areas. Many unqualified “practitioners” use unsterilized needles for multiple patients, transmitting viral hepatitis to many. It is of paramount importance to avoid these “practitioners”. Needle-sharing among intravenous drug users is another major route of infection.
How can we treat viral hepatitis?
Hepatitis C has been the bane of liver specialists since it was discovered back in 1989. It was deadly, and notoriously difficult to treat. Patient needed weekly or more frequent injections for upto a year, which were expensive, toxic, and had poor treatment rates. Since 2015, the availability of safe and effective oral drugs has changed the game entirely. Now, 3 months of a single pill can effectively cure hepatitis C. Moreover, the testing and treatment are both provided free of cost under the National Viral Hepatitis Control Program.
Hepatitis B is the other big cause for cirrhosis and liver cancer. While it is notoriously difficult to completely cure, it can be kept under check with a single pill a day. Screening tests and treatment for hepatitis B are also available free of cost under the National Viral Hepatitis Control Program.
Who should be screened for viral hepatitis?
Treatment of liver cirrhosis and liver cancers due to viral hepatitis is difficult and expensive. However, preventing the development of these conditions is quite simple once the virus is identified. Unfortunately, most people who have these viruses remain perfectly well until the damage is done, thus, never get tested until it is too late. The best way to identify the virus, thus, is to test all whose we can. In an ideal world, we would like everyone to be screened. However, it is an absolute must for the following groups
· Know liver problems in self or a family member
· Received unsterile injections/ Underwent any invasive procedure by an unqualified medical ‘practitioner’
· Received blood/ blood product transfusion before 2002
· Have any tattoos
· Current or past drug use
Let us eliminate viral hepatitis
Viral hepatitis is a major health hazard with potentially serious and deadly complication. However, it can be treated. With testing and treatment both covered under government programs, I can’t wait for this highly preventable and treatable suffering to be over. Let us raise awareness among all those we know, get screened, and get treated for hepatitis.
