Hepatitis – a global health concern
Dr K Romeo Singh *
Rally on World Hepatitis Day from Kangla on July 31 2016 :: Pix - TSE
Hepatitis is a term used to describe the inflammation of the liver as a result of viral infection or exposure to harmful or toxic substances such as drugs or alcohol.
While some types of hepatitis will pass without causing permanent damage to the liver, chronic cases can cause cirrhosis, liver failure or cancer.
There are five main hepatitis viruses, referred to as types A, B, C, D and E, which pose the greatest risk. Hepatitis B (HBV) and C (HCV) are viral infections which can cause chronic hepatitis and are the leading causes for hepatic cirrhosis and cancer, thus creating a significant burden to healthcare systems due to the high morbidity / mortality and costs of treatment.
Around 70-80% of people with Hepatitis B or C do not even have any symptoms. The symptoms often go unnoticed, the reason why this disease is also known as the ‘silent killer’.
Approximately 1 in 12 persons worldwide, or some 5– million people, are living with chronic viral hepatitis. About 15 million Indians are anti-HCV positive and 5 million of them may be viraemic. Of these, nearly 25%, i.e. over 1 million, may develop chronic liver disease within 2 decades and 1% – 4% of them may develop liver cancer.
Annually, in India about 240,000 people die of rival hepatitis or its sequelae. About 170-200 million people worldwide are chronically infected with hepatitis C virus, and more than 250,000 people die from hepatitis C-related liver diseases each year.
There are an estimated 2-4 million people in the United States, 5 to 10 million people in Europe and about 15 million people in India who are chronically infected with HCV, HCV has six major genotypes, referred to as genotypes 1 through 6. It is important for the treating physician to determine which HCV genotype a patient has, as this information can impact decisions regarding the type and duration of treatment.
Genotype 1 has been found to be associated with a poor response to antiviral treatment. Genotype 1 is also the most common form of HCV, accounting for about 60 percent of global infections. In studies carried out in different regions of India, genotype 3 has been the most commonly identified genotype.
The major risk factor for HCV infection is parenteral exposure, primarily through blood products and needle sharing among injecting drug user.
People at risk are :-
1. Recipients of previously unscreened blood, blood products and organs.
2. Patients and employees in hemodialysis centres (nosocomial infections).
3. Hemophiliacs-Injecting drug users sharing contaminated needles and / or injection materials.
4. People exposed to unsterile medical or dental equipment.
5. Occupation exposure to blood.
6. People administering or receiving acupuncture and/or tattooing with unsterile medical devices.
7. Health care workers.
8. Sexual household and
9. Perinatal transmission – Infants born to infected mothers.
Screening for HCV among blood donors has reduced the risk of acquiring HCV from blood products by half to two thirds. Some people acquire the infection through non-parenteral means that have not been fully defined, but include sexual transmission in persons with high risk behaviors, although transmission of HCV is generally less common than that of HBV and HIV.
* Dr K Romeo Singh wrote this article for The Sangai Express
This article was posted on August 01, 2016.
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