Hepatitis: Elimination through Education

Hepatitis: Elimination through Education 

Hepatitis is defined as an inflammation of the liver, which in most cases is caused by hepatitis viruses A, B, C, D and E among other factors. According to World Health Organisation, there are 325 million people who are suffering from hepatitis B and C with over 1.3 million fatalities annually across the world. In India, 40 million people are chronically infected with Hepatitis B virus and 6 to 12 million with Hepatitis C virus. A cause of serious concern is that only about 20% of these patients have access to testing, information about prevention and treatment. Worldwide, about 290 million people are suffering from these viral infections without even being aware about it. And hence, it becomes even more important to initiate an action plan to find these “missing millions” through health awareness initiatives. This will ensure that these people get adequate and proper care and don’t suffer. 

With 2020’s theme for World Hepatitis Day being “Hepatitis-free future”, it becomes all the more crucial to know about the nature, prevention and treatment of these viral illnesses. Hepatitis A and E are usually self-limited infections and comparatively not as severe as the other types. Hepatitis B and C are the leading causes of hepatitis-related deaths and can lead to serious conditions and cause long-term liver damage like liver cirrhosis, acute on chronic liver failure, liver cancer or even death. Hepatitis D, usually occurs in conjunction with Hepatitis B. Hepatitis B and C especially pose a serious threat to India as suggested by the numbers. 

The most common symptoms of these viruses include loss of appetite, yellow discolouration of skin and eyes (jaundice), pale stools, dark urine, abdominal pain, joint pain, fatigue, sudden weight loss, nausea, fever, vomiting, etc. However, apart from these common symptoms, there are cases where the symptoms don’t show until liver damage occurs. Some patients with viral Hepatitis A, B and E can present with sudden deterioration, jaundice, drowsiness and coma, often referred to as acute liver failure. Many a times, it becomes difficult to identify patients with Hepatitis B and C, as symptoms do not appear until about 80% of liver is damaged. Patients with liver cirrhosis due to viral hepatitis B and C can have jaundice, fluid in the abdomen (ascites), bleeding from gastrointestinal tract, blood clotting problems and affection of brain, kidneys and lungs due to liver damage. Knowledge about the risk factors and getting a diagnostic test done when someone has risk factors, are the main pillars in combating hepatitis. The diagnosis usually involves a physical examination, liver function tests, and blood tests to determine the type and load of the virus in the body.  

Once diagnosed, the course of treatment is based on whether the infection is acute or chronic. In the current scenario, it is vital to get a test and have the medications started, as those with pre-existing health conditions are at a higher risk of contracting COVID-19 virus. An increased awareness through campaigns, initiatives and discussions will help spread information as well as reduce the stigma about the disease. Awareness will also enable access to testing, ultimately resulting in early diagnosis.  

Hepatitis B and C, although chronic diseases, have treatment in the form of antivirals. Patients with chronic hepatitis B and C require regular monitoring and evaluation (surveillance) for liver cancer. The CDC recommends administration of Hepatitis B vaccine to all newborns. The vaccine is also recommended for adults who are at high risk of contracting Hepatitis B, and it is an extremely effective way for prevention. Hepatitis C is now curable with antiviral medications. Apart from following the prescribed treatment, it is also crucial to follow hygiene practices such that the disease does not spread to others. 

In conclusion, educating the masses is the way forward to find these “missing millions” and ensuring that they receive proper treatment and care. Only then, will we be able to drastically reduce the number of patients who would suffer from these diseases and in due course eliminate the risk of the virus and achieve the dream of “Hepatitis-free” India.