By: Priyanjali Ghose Date: 2011-08-09 Place: Mumbai
What you need to know about the potentially life-threatening liver infection caused by the Hepatitus B virus
A recent finding by doctors from MIOT Hospital in Chennai claims that India is likely to emerge as the global capital of the dreaded Hepatitis B virus, which is responsible for 60 per cent of liver cancer cases.
Ashok Borisa, a Gastrointestinal and Laparoscopic Hepato-Pancreato-Biliary surgeon, Fortis Hospitals says, "The number of HBsAg carriers in India is estimated to be over 40 million or four crores."
Lack of awareness about the virus is a large reason for the spread of the virus, claim doctors. Viral Patrawala, gastroenterologist, Hiranandani Hospital defines Hepatitis B as a serious liver inflammation and infection caused by the hepatitis B virus (HBV).
Five kinds of virus
A, B, C, D and E are the five kinds of Hepatitis. Patrawala broadly classifies A and C to be food and water-borne infections, while B and C are spread through contact with blood or other bodily fluids including saliva, semen and vaginal fluid of an infected person.
Patrawala explains that carrying the virus does not mean that an individual has the disease. He declares that HBV can cause both short-term (acute) disease and long-term (chronic) disease.
"Not everybody develops chronic infection. Only five per cent of those carrying the infection develop the chronic disease," clarifies Patrawala. He adds that being affected by Hepatitis B does not depend on age or gender though children are more prone to develop the chronic disease, as compared to adults.
Consultant gastroenterologist Prassana Shah from Breach Candy says, "Anybody can acquire acute Hepatitis B.
However, in most cases the body produces antibodies and suppresses the virus with regular administration of drug tests. The person is cured mostly in six months," says Shah.
He says that in India, 90 per cent cases show that the infection mostly spreads from mother to foetus and most of them are chronic. Most pregnant women suffering from Hepatitis B are given injections to protect the child from the virus. Also, according to him, blood transfusion, dental treatment and the use of infected needles and razors are other major causes of the spread of Hepatitis B.
Symptoms and cure
Borisa says that the signs of Hepatitis B appear in about three months after being infected. Abdominal and joint pain, dark urine, loss of appetite, nausea and vomiting, weakness and fatigue, and jaundice are some of the symptoms. In case of acute HBV, the doctors may not suggest any treatment and instead work to reduce the symptoms and recommend follow-up blood, liver and viral load tests to make sure the virus has left the body.
However, Borisa informs that those suffering from chronic HBV infection often do not feel any discomfort even after carrying the infection for decades. According to him, 15 to 20 per cent of the patients suffering from chronic Hepatitis B die of liver cancer and cirrhosis, the scarring of liver.
"If you've been diagnosed with chronic hepatitis B infection, your doctor may recommend antiviral medications or getting a liver transplant," says Borisa.
Vaccination, a must?
Experts unanimously agree that vaccination is the best protection against the Hepatitis B virus. Ajay Choksi, gastroenterologist from Nanavati Hospital informs that World Health Organisation has recommended that HBV vaccination should be provided to all adults and infants at the time of birth. "The WHO has made a recommendation, but in India vaccination has not yet been made mandatory in all private and government hospitals. There is no such regulation though most pediatricians normally vaccinate children."
Shah gives the example of Taiwan where Hepatitis B vaccination programme was implemented in 1984. As a result, Taiwan saw a considerable decline of hepatocellular carcinoma or liver cancer in children.
In India each shot, according to Choksi is priced between Rs 50 to 100. Three shots of the vaccine are needed for proper protection. Though there is no age limit, it is advisable to take the HBV vaccine before the age of 40.
Apart from proper vaccination, Borisa advises that maintenance of national registry for Hepatitis, treatment of carriers, educating the common man, availability of treatment for chronic HBV for all classes and proper check on blood blanks be done to curb the spread of the virus.
42 million Indians suffer from Hepatitis B: Study
A recent study by a team of doctors from MIOT Hospital in Chennai conducted a survey which showed that 42 million Indians suffer from chronic Hepatitis B. the virus is also responsible for 60 percent of liver cancer cases in the country, claim the doctors. It was also found that not even one per cent of school children are provided with HBV vaccine though it was developed in 1970. PVA Mohandas, director, MIOT Hospital, reveals that there are 400 million people chronically infected by the HBV and 40 per cent of them are at the risk of suffering from cirrhosis and liver cancer.
Do's and Don'ts for those living with HBV
Dos
> Restrict alcohol intake to a peg twice or thrice a week if you have chronic HBV.
> Practice safe sex. Use condoms each time you have sex. If you are in a monogamous relationship and have had unprotected sex outside your relationship, confide in your partner, as you might be putting them at risk of contracting the virus or an STD (sexually transmitted disease).
> If you are pregnant and carrying the HBV tell the doctor immediately.
Don'ts
> Alcohol, even wine, is an absolute no-no if you have contracted the virus.
> If you are infected with the Hepatitis B virus, don't donate blood or organs.
> Don't share razor blades or toothbrushes. These items may carry traces of infected blood. If you use IV drugs, never share your needles and syringes with anyone.
Myths and truths about Hepatitis B
Myth: Hepatitis B can be transmitted through casual contact such as kissing, handshakes or sharing of food and water.
Truth: The disease can only be contracted on an intimate basis such as sharing bodily fluids through unprotected sex or sexual contact or through blood transfusions with an infected person.
Myth: There is no treatment available for chronic hepatitis B.
Truth: While the disease is not curable, it is manageable. Chronic HBV can be treated with a number of effective medications that can suppress, slow or reverse the liver disease. All chronically infected patients need life-long monitoring.
Myth: Healthy patients with chronic HBV (often called "carriers") do not need regular medical follow-ups.
Truth: Inactive carriers can progress to cirrhosis or liver cancer at any time. Continued screening should take place at regular intervals throughout the patient's lifetime.
Myth: Hepatitis B vaccine prevents liver cancer and enhances healing in infected patients.
Truth: The vaccine prevents infection and thereby cancer. There is no reason to vaccinate a patient who is already infected.
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