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According to the WHO, about four in every 100 Indians are infected, equivalent to 40 million infected people in India. Most are happily oblivious because the virus produces few symptoms for long periods. By the time symptoms of liver disease appear, the disease is often considered advanced.
Hepatitis B is one of the leading causes of liver failure and liver cancer. All 12 people in the world are infected, and liver disease is the 12th leading cause of death. And the tragedy is that it is avoidable. The impact of hepatitis B and C on health is at least ten times higher than that of HIV, while awareness and funding for HIV are far behind those of AIDS.
Government reluctance to include vaccination against hepatitis B in the childhood immunization program until recently fallen in the ear of a deaf man. In 2010, infants in about 150 countries around the world were systematically vaccinated. This strategy has helped reduce 20-fold hepatitis B in some countries such as China. Our government was firm on the grounds of lack of funds and made the world wonder how a country that organizes IPL with such fanfare could really mean that.
Image of representation. Reuters
India started late with its hepatitis B awareness and prevention strategy and is quickly trying to catch up. He used Amitabh Bachchan's services in his campaign, introduced immunization into the infant immunization program at the beginning of this decade and very intelligently introduced screening for hepatitis B into the balance sheet. prenatal; This is crucial because the infection cycle uses the mother-infant pathway. Therefore, interrupting it during deliveries with rapid recognition and rapid vaccination is a very sensible approach.
In addition, the vaccine, which includes three doses delivered by injections at 0, 1 and 6 months, is now readily available and affordable. It cost Rs 500 for each dose in the 1990s, but now costs about Rs 50.
Another virus, the hepatitis C virus, is also becoming a major cause of cirrhosis of the liver and of liver cancer. Screening studies have shown that one percent of the Indian population can be infected without knowing it, often spreading it to other people through transfused blood or reused needles for injections. It is estimated that 10 million Indians have the infection. Unlike hepatitis B, however, there is still no vaccine against hepatitis C.
Here, India has acted with incredible speed. When new generation oral tablets such as sofosbuvir, ledipasvir, daclatasvir and velpatasvir were introduced to the western world as breakthrough molecules in 2014-15, their price was $ 1,000 per tablet, to be taken during 90 days. Clearly, this put these therapies out of reach of the Indians. Our government has authorized the manufacture, marketing and sale of these compounds at one percent of the international price, making this new treatment accessible to most people.
The hepatitis B virus can infect other members of the family; therefore, all family members of an infected person should be screened. In a study in which families of 225 patients who had tested positive for hepatitis B were screened, additional infected individuals were detected in 45 (20%)
How are they transmitted ?
Hepatitis B and C are transmitted by infected blood or blood products, needles and non-reusable syringes, improperly reused catheters and equipment, tattooing, piercing ears, sharing blades and razors, etc. Infected mothers can unknowingly transmit hepatitis B to their offspring. It can also be transmitted through sexual contact with an infected partner.
Hepatitis B and C are not transmitted through food, water or the sharing of utensils or shaking hands
Who are at risk and should be tested?
Anyone with a history of blood transfusion or surgery, or having a history of jaundice, or if a family member is suffering from liver disease, should undergo testing. It is a must for all health care workers (hospital employees, retirement homes, blood banks or laboratories). Patients with blood disorders such as thalassemia, which require regular blood transfusions, are at high risk.
Are they treatable?
Both are treatable.
Hepatitis B can now be treated orally. Drugs: At least five drugs are approved and marketed. Treatment is required only for people who have an active infection and should be taken for long periods, often years. If the liver is severely damaged and is unable to perform its job, it may need to be replaced by a liver transplant.
Hepatitis C can also be treated and requires the combined use of weekly injections and oral medications for periods of 6 to 12 months. If the disease is too advanced, these drugs can not be used and the liver needs to be replaced.
For hepatitis B and hepatitis C, treatment is most effective if initiated at an early stage
. Hepatitis C prevalence rates are still low, but largely because of the increase in UDDI in the northern and eastern states. from the East. But attention now needs to shift from the clinic to the community, creating increased awareness, broader prevention strategies and bringing more patients under the treatment umbrella at the start of the infection.
The author is director and head of the department of gastroenterology. Hepatobiliary Sciences, Fortis Medical Research Institute (1965)! Function (f, b, e, v, n, t, s) {if (f.fbq) returns; n = f.fbq = function () {n.callMethod?
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