27th August 2023,Mumbai: The Rising Challenge: Hepatitis B and C Take the Lead
Hepatitis B and C have emerged as the leading chronic infectious diseases in India, surpassing even HIV and Tuberculosis. These diseases, caused by inflammation of the liver, are primarily brought about by hepatitis viruses, with five main types identified: A, B, C, D, and E. While A and E generally cause short-term infections, it’s the persistent and chronic nature of hepatitis B and C that poses a significant threat.
Transmission and Prevalence
Interviewed for insights, Dr. Mayur Manji Mewada, Associate Professor and Unit Head at the Department of Medicine in KJ Somaiya Medical College and Research Centre, Mumbai, highlighted the major causes behind chronic Hepatitis B and C infections. These include unprotected sexual contact, unsafe blood transfusions, unhygienic tattoo practices, and the sharing of razors. Disturbingly, around 4 crore Indians are chronic carriers of Hepatitis B, while approximately 1.2 crore individuals carry Hepatitis C infections. Worryingly, one in four people affected by Hepatitis B or C eventually progresses to develop cirrhosis and hepatocellular carcinoma, or liver cancer.
The Grim Outcomes: Cirrhosis and Liver Cancer
Dr. Mewada emphasized that cirrhosis of the liver and liver cancer lead to premature or untimely deaths. However, these fatalities can be averted through effective treatment and vaccination strategies. The National Viral Hepatitis Control Program (NVHCP), initiated by the Ministry of Health and Family Welfare on July 28, 2018, aims to combat chronic Hepatitis infections and eliminate Hepatitis C nationwide by 2030. Education, mandatory vaccination for newborns and healthcare workers, as well as proper awareness about the risks, can prevent the spread of new Hepatitis infections. For those already infected, appropriate antiviral medications, such as Directly Acting Antivirals (DAAs), offer hope for recovery. Thus, Hepatitis B and C infections, though serious, are reversible factors contributing to liver cancer.
Understanding the Viral Causes of Hepatitis
Dr. Amitabh M. Keny, MD, a Consultant Physician, Diabetologist, and Cardiologist, weighed in on the common causes of hepatitis and the viruses responsible for the disease. Viral infections, alcohol abuse, drug use, and autoimmune responses can all contribute to hepatitis. Among the viruses, Hepatitis A, B, C, D, and E are the primary culprits. Understanding their modes of transmission sheds light on the pervasive nature of these infections:
- Hepatitis B and C Transmission: These viruses spread through unprotected sexual contact, blood transfusions, needle sharing, and from mother to child during childbirth.
- Hepatitis A and E Transmission: These viruses primarily spread through contaminated food and water, making them particularly concerning during monsoon seasons.
Long-Term Implications: Cirrhosis and Liver Cancer
While Hepatitis A and E infections tend to result in a self-limiting illness lasting 3 to 6 weeks, Hepatitis B and C infections can persist for a long time within the body, leading to severe consequences such as liver cirrhosis and ultimately, liver cancer.
Preventing Hepatitis: Key Measures
Preventing hepatitis is feasible through a series of measures that promote safe practices and hygiene. Dr. Keny outlined these crucial steps:
- Safe Sex and Hygiene: Practicing safe sex and avoiding the sharing of blades and needles can significantly reduce the risk of transmission.
- Hygienic Food and Water: Ensuring the hygienic preparation of food and boiling water can counter the spread of Hepatitis A and E, particularly in monsoon-prone areas.
- Caution with Food Sources: Steering clear of uncooked or street food prepared under unhygienic conditions can prevent infection.
- Screening Pregnant Women: Regularly screening pregnant women for hepatitis viruses can help identify infections early, leading to timely interventions.
Hepatitis B and C have emerged as formidable challenges in India’s health landscape, surpassing even well-known infections like HIV and Tuberculosis. The chronic nature of these infections, coupled with their potential to cause severe liver conditions and cancer, highlights the urgent need for awareness, preventive measures, and effective treatment strategies. As the nation strives to eliminate these infections by 2030 through initiatives like the NVHCP, collective efforts from healthcare professionals, policymakers, and individuals are crucial to curbing the prevalence of Hepatitis and its devastating consequences.
-by Kashvi Gala