Hepatitis B virus: Prevention over cure should be the approach India needs

Published: June 28, 2019 1:01:15 PM

Hepatitis B Virus gnaws at the liver and eventually leads to liver ‘Cirrhosis’, which means the scarring of the liver.

Hepatitis B (Source: Thinkstock Images)Hepatitis B (Source: Thinkstock Images)

By Dr. Dharmesh Kapoor, Hepatologist

Leading a healthy lifestyle can be a challenge in today’s time-bound world. While most of us attempt to inculcate habits of consuming healthy food and regular exercise, regular health check-ups rarely figure in our conversations. Healthcare, especially in India, is a major challenge for the people and the providers. Our large population, unequal access to healthcare due to expenses, lack of manpower, are some of the issues that continue to plague the sector despite the efforts of the government to decrease the disease burden of the country. Preventive healthcare often takes a backseat, while it can prove to be the solution for a number of diseases, one such problem being the Hepatitis B Virus (HBV).

HBV is a highly contagious virus and the avenues for a cure in this condition are limited if not identified in time. In most cases, the problem is identified with yellowing of skin or Jaundice, fever, nausea, joint pain, abdominal pain, dark urine, loss of appetite, vomiting, and weakness.

Adults, upon early detection and treatment, tend to recover. Otherwise, the problem has the potential to become chronic. The virus gnaws at the liver and eventually leads to liver ‘Cirrhosis’, which means the scarring of the liver, or even liver cancer. Chronic hepatitis B is the commonest cause of liver cancer in India.

Prevalence of Hepatitis B virus in India
In a country like India, where substandard, ill-informed, and unhygienic medical practices are major issues in the delivery of healthcare, a blood-borne and highly contagious virus like the hepatitis B virus has many avenues to thrive and spread.

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According to a 2017 report by WHO, hepatitis claims close to one and a half million lives each year, and Hepatitis B, out of all the viruses, is leading the pack. It claims nearly 6,00,000 lives every year in India. Further WHO claims that in India, as per latest estimates, 40 million people are chronically infected with hepatitis B, second only to China, and most of them are unaware of it, which keeps them at the risk of developing cirrhosis or liver cancer.

Causes of Hepatitis B
One of the most notorious aspects of this virus is how easily it spreads. Hepatitis is a blood-borne virus, it mainly spreads through the blood. It is deemed ten times more contagious than HIV.

In India, it is mainly caused by blood transfusions with unscreened blood, unsafe surgical procedures and medical practices, like the use of unsterile needles and equipment during a dental examination. Intravenous drug users and even diabetics are at a higher risk because of unsafe needles.

Other causes include sharing personal care items like razors and toothbrushes. Unprotected sex with an infected person may also be a cause.

Prevention of Hepatitis B
While the issue is daunting and wide-spread, simple measures can help us prevent this disease from claiming further lives. A regular health check-up, which we often identify as a burden on our budgets can help us identify the infection timely and seek an expert opinion regarding its management. The infection can be prevented by a cheap, yet efficacious vaccine, which is readily available.

The Healthcare sector in India shall have to get its act together. Healthcare professionals should be aware of their hepatitis B virus status.

Those who are immunized should know that they have protective antibodies in the serum or not. If not, a vaccine booster dose can augment the circulating antibodies.

Regardless of the speciality we work in, it should become a habit for all of us to test for viral markers in all patients, and those found negative for hepatitis B virus infection to be vaccinated.

Patients who undergo maintainence hemodialysis and those who need multiple transfusions (e.g; thalassemics, hemophialics) contribute a special group and should be carefully monitored for breakthrough infections.

The vaccine is safe in pregnancy and all pregnant ladies should receive it in ante-natal clinics.

If we are resolute, there is no reason why we can not overcome the scourge of this infection, both by safe medical practices and simple preventive interventions.

(Dr. Dharmesh Kapoor is a Hepatologist, Gleneagles Global Hospitals, Hyderabad. Views expressed are the author’s own.)

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