Dr Shoket Chowdhary
Dr. Vinay Sambyal
Every year on 28 July, WHO and partners mark World Hepatitis Day to increase the awareness and understanding of viral hepatitis and the diseases that it causes.It includes group of hepatitis viruses A,B,C,D and E.
The theme of 2014 would be “Hepatitis: Think Again “.
WHY WORLD HEPATITIS DAY IS CELEBRATED?
World hepatitis day is celebrated annually to encourage the common public for the early diagnosis, prevention and treatment from hepatitis.
WHAT GOES ON?
The 2014 campaign will focus on the theme Hepatitis: think again.
The message from this theme is that viral hepatitis is being ignored around the world .Viral hepatitis is the 8th bigger killer worldwide .It kills 1.5 million people worldwide each year -that’s as many people as HIV/AIDS.
WHAT IS HEPATITIS?
Viral hepatitis- a group of infectious diseases known as Hepatitis A,B,C,D and E – affects hundreds of millions of people worldwide ,causing acute and chronic liver diseases and killing close to 1.4 million people every year .But hepatitis remains largely ignored or unknown. Hepatitis is the liver inflammation caused by these viruses. A and E type are short term infection and known as acute infection however B,C and D type are long-term infection and called as chronic hepatitis .Hepatitis B,and C can lead to some life threatening complications including cirrhosis means liver scarring, liver cancer, liver failure and so many.
HOW THE DISEASE PRESENTS?
Acute viral hepatitis occurs after an incubation period that varies according to the responsible virus. The prodromal symptoms of acute viral hepatitis are systemic and quite variable.
Constitutionalsymptomslikeanorexia,nausea,vomiting,fatigue,malaise,arthralgias,myalgias,headache,photophobia,pharyngitis,cough,coryza may precede the onset of jaundice by 1-2 weeks. Dark urine and clay-colored stools may be noticed by the patient from 1-5 days before the onset of clinical jaundice. Complete clinical and biochemical recovery is to be expected 1-2 months after all cases of hepatitis A and E and 3-4 months after the onset of jaundice in three quarters of uncomplicated ,self -limited cases of hepatitis B and C (among healthy adults, acute hepatitis B is self limited in 95-99% while hepatitis C is self limited in only -15%)
METHODS OF TRASMISSION
Hepatitis A
* Hepatitis A is a liver disease caused by the hepatitis A virus that can cause mild to severe illness but does not lead to chronic infection.
* Globally, there are an estimated 1.4 million cases of hepatitis A every year.
* The hepatitis A virus is spread by ingestion of contaminated food and water, or through direct contact with an infectious person.
Hepatitis A is a virus that is usually spread through food or water contaminated with fecal matter-even in microscopic amounts. This occurs most often in countries where Hepatitis A is common, especially where there is a lack of safe water and poor sanitation.
Although rare, foodborne outbreaks of Hepatitis A still occur in the United States. Then one can imagine the scenario in India. Contamination of food can happen at any point: growing, harvesting, processing, handling, and even after cooking. The best way to prevent getting infected with Hepatitis A is to get a safe, effective vaccine. In the United States, the Hepatitis A vaccine is recommended for all children at age 1 and adults at risk of infection but vaccination in India is controversial due to frequent chances of re-infection due to poor sanitation.
Hepatitis B
* Hepatitis B is a serious liver disease caused by the hepatitis B virus that can cause both acute and chronic disease.
* Globally, there are an estimated 240 million people living with chronic Hepatitis B.
The hepatitis B virus is spread through contact with the blood or other body fluids of an infected person. Hepatitis B is spread when blood, semen, or other bodily fluid of someone who has it enters the body of someone who doesn’t. An infected mother can pass the disease on to her child at birth. You can also get the disease by:
* Having unprotected sex with an infected partner
* Sharing needles, syringes, or other drug paraphernalia
* Using something that may contain an infected person’s blood, such as a razor or toothbrush
* Coming in direct contact with the blood of someone who has the disease
* Being exposed to blood from needle sticks or other sharp instruments.
Hepatitis C
* Hepatitis C is a serious liver disease caused by the hepatitis C virus that can cause both acute and chronic disease.
* Globally, there are an estimated 130-150 million people living with chronic Hepatitis C.
* The hepatitis C virus is a bloodborne virus.
* There is currently no vaccine for hepatitis C.
Unlike Hepatitis A and Hepatitis B, there is no vaccine available to prevent Hepatitis C. The best way to prevent Hepatitis C is by avoiding behaviors that can spread the disease, such as sharing needles or other equipment to prepare and inject cosmetic substances, drugs, or steroids.
People with Hepatitis C often have no symptoms and can live with the disease for decades without feeling sick. Even without symptoms, liver damage may be silently occurring. Fortunately, new treatments are available that can cure Hepatitis C.
Hepatitis D
It generally co exit with Hepatitis B infection.
Hepatitis E-It is also transmitted by contaminated food and water.
HIGH RISK POPULATION FOR WHICH HBV INFECTION SCREENING RECOMMENDED
a) Household and sexual contacts of persons with hepatitis B
b) Person who are addicted to intravenous drugs.
c) Persons with multiple sexual contacts or a history of Sexually transmitted diseases.
d) Persons with elevated Liver enzymes ( SGOT & SGPT) levels.
e) Persons with HCV or HIV infection.
f) Patients and staff of Hemodialysis ward
g) Pregnant women
h) Persons who require immunosuppressive or cytotoxic therapy ( Cancer patients ) and health care professionals attending them
i) Health care Personnels
J) Persons with hemophilia and other congenital bleeding disorders
PROPHYLAXIS OF HEPATITIS
General (lifestyle modification): Alcohol consumption should be stopped, cigarette smokers should be advised to quit, weight reduction with sound nutritional advice is ideal. Eat plenty of vegetables, legumes and fruits. Take sugarcane (milk thistle), eat plenty of cereals, preferably whole grain, lean meat, fish, poultry, milk, yoghurt, cheese and regularly drink water. Avoid groundnut! Groundnut contain toxins (aflatoxin) that are injurious to the liver.
The author are Head Gastroenterology SSH Jammu and Registrar Gastroenterology SSH Jammu.
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