Dr. Gourdas Choudhuri:
As the world gears up to celebrate World Hepatitis Day once again today, it is time to look back at what scientists, governments and NGOs have achieved so far and where they have failed.
To provide the backdrop for those who are new to the subject, we now know about 5 major hepatitis viruses, A,B,C,D and E that specifically attack the liver and kill liver cells. Hepatitis A and E are spread through infected food and water, produce short lasting “acute hepatitis” or the common jaundice and usually recover in 4 to 8 weeks when the body mounts a good fight and knocks the virus out. There is a vaccine available for Hepatitis A that children and some adults can benefit from. There is no vaccine for Hepatitis E yet.
Hepatitis B and C are the stealthy viruses that enter the body surreptitiously through infected needles and injections, pokes (body piercing, tattoo), blood transfusions or through sex. Hepatitis B is the commoner one which also spreads unknowingly from symptomless infected mothers to their offsprings, thus keeping the virus in circulation with around 5% of the global population showing evidence of infection.
Due to ongoing liver damage over years that go undetected due to lack of symptoms, infection with these viruses often cause a state of irreversible liver damage and scarring called liver cirrhosis. Chronic infection with these 2 viruses also causes Liver cancer, a fatal disease that claims a million lives each year.
The adage “Prevention is better than cure” could not be more appropriate for Hepatitis B. A very effective screening blood test (HbsAg) is available to detect those who are infected and could be brought under treatment with safe affordable oral medicines ( 6 drugs are now available) Those who are not infected can be protected for life with 3 doses of a very safe, affordable and effective vaccine.
What then is the reason that hepatitis still damages livers and kill through liver cirrhosis and cancer? The gap seems to be at the level of translating science to societal practice. Most individuals, even the educated ones in India, are not aware of their Hepatitis status. Many have thought of, but never really got down to taking the easily affordable vaccine. And the lethargy seems to resonante in our health policy where ante-natal screening for Hepatitis B and vaccination of all newborns has not yet become a widely prevalent practice as in dveloped countries.
Scientists have a long way to go too. They are still far from being able to makie vaccines for Hepatitis E and Hepatitis C. Also, the treatment of the latter infection is still cumbersome with weekly toxic expensive injections that need to be taken for 6 to 12 months.
The theme for this year’s World Hepatitis Day is “It is closer than you think”. It would be appropriate to get ourselves checked and vaccinated this year! Prevention is after all much better than cure!
[box bg=”#fdf78c” color=”#000″]About the author:
Dr. Gourdas Choudhuri is the Vice-Chairman, Institute of Digestive and Hepato-biliary Sciences, Medanta – The Medicity. He has also been the past President of the Indian Society of Gastroenterology, and Former Professor and Head, Department of Gastroenterology
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.[/box]