Medical Experts across India Call for More Education, Awareness on World Hepatitis Day
Hepatitis viruses are estimated to be among the top ten causes of death in India [2]

Varsha Chainani *

World Hepatitis Day :: Pix - wikipedia.org

On July 28, World Hepatitis Day, Abbott joins the efforts of organisations such as the World Health Organisation (WHO) and collaborates with local medical experts to increase awareness and understanding of viral hepatitis and the diseases it causes. Hepatitis viruses constitute a major health risk as they cause acute and chronic infection and inflammation of the liver leading to cirrhosis and liver cancer. Experts in India are calling for greater focus around hepatitis education and screening among high-risk communities and populations in India.

Hepatitis viruses A, B, C, D and E are estimated to be among the top ten causes of death in India [2]. According to the World Health Organization, 240 million people globally are chronically infected with Hepatitis B and around 150 million chronically infected with Hepatitis C [1]. In India, doctors specialising in liver disease are primarily focused on increasing awareness about Hepatitis B (HBV) and Hepatitis C (HCV), as they cause chronic infection and are most difficult to treat.

Dr. Anil Arora, Chairman and HOD – Department of Gastroenterology And Hepatology, Sir Ganga Ram Hospital, New Delhi says "Hepatitis B (HBV) and Hepatitis C (HCV) infections are 'silent' diseases that remain asymptomatic for decades. Due to lower awareness, more than 80% HCV patients and over 60% patients with HBV are diagnosed at a stage when the disease is irreversible. Unhygienic use of needles in acupuncture and tattooing has significant potential in spreading the infections. Alcoholics are also 2-3 times more prone for developing Hepatitis B & C. In my practice, I am seeing more and more youngsters fall prey to Hepatitis infections. If anyone has symptoms such as jaundice, continued fatigue, itching all over the body, fever and abdominal pain they must be tested for Hepatitis for timely diagnosis and treatment."

India is at the intermediate endemic level of Hepatitis B, with Hepatitis B surface antigen (HBsAg) prevalence between 2% and 10% among the populations studied. [3] As for Hepatitis C, one out of every hundred persons in India may be chronically infected by the virus and most among these 12 million persons do not know they are infected.[4] Prevalence of Hepatitis C has been observed to be relatively higher in Punjab, Andhra Pradesh, Puducherry, Arunachal Pradesh and Mizoram. Interestingly, several studies conducted in these states highlight different risk factors which are believed to have led to the relatively higher prevalence of the condition.

The prevalence of HCV is also found to be high in some states in Northeast India. A study conducted in Arunachal Pradesh showed a prevalence of 7.89%.7 It has been noted that unsafe behaviour among injecting drug users is the driving factor behind HCV epidemics in Northeast India.[9 ]

Dr. N. Biplab Singh, Professor - Department of Medicine, Regional Institute of Medical Sciences, Imphal says "It is alarming to see high prevalence of Hepatitis B and C infections in Northeast India specifically in Mizoram and Arunachal Pradesh. A recent study done in Mizoram showed that prevalence of HCV was 71.2 per cent among the active injection drug addicts.[8] Studies done in Manipur have revealed that the prevalence of Hepatitis C among patients with chronic liver disease was 46.21% and the co-infection with HIV-HCV among chronic liver disease was 18%. The highest number of HCV cases was found in two districts of Manipur - Imphal West (36.81%) and Churachandpur district (21.6)."

In a recent study conducted in Punjab, prevalence of HCV infection was found to be 5.2 %, with the highest prevalence noticed in the 41–60 years age group. Various risk factors for acquiring HCV infection identified were history of surgery, dental treatment and unprotected sex.[5]

In another study from Puducherry, the prevalence of HCV in a sub-population of STD patients was as high as 6% [6].

In some studies conducted in Andhra Pradesh, cultural practices such as tattooing, traditional medicine (e.g. bloodletting), rituals among pilgrims (e.g. scarification) and body piercing have been observed to lead to a significantly higher rate of HCV transmission. HCV prevalence rates of 1.4%, 2.02% and 6.1% have been noted in different studies conducted in tribal and other populations in Andhra Pradesh [6,10,11 ]

On the occasion of World Hepatitis Day, Abbott endeavours to work with medical experts in India and provide support in communicating with at-risk populations, enhancing awareness about hepatitis.

About Abbott

Abbott is a global healthcare company devoted to improving life through the development of products and technologies that span the breadth of healthcare. With a portfolio of leading, science-based offerings in diagnostics, medical devices, nutritionals and branded generic pharmaceuticals, Abbott serves people in more than 150 countries and employs approximately 70,000 people.

In India, Abbott has more than 12,000 employees working in manufacturing, research and development, logistics, sales and marketing and is headquartered in Mumbai.

References :

1. World Hepatitis Day. WHO Campaigns. Available from: Link here . Accessed on 13th July 2013.
2. Liver diseases. National Liver Foundation. Available from: Link here. Accessed on 13th July 2013
3. Martha Bhaskar Rao. The prevalence of hepatitis B in India and its prevention. 2012. 19(4). Available from: Link here. Accessed on 12th July 2013
4. Hepatitis C. Global Alert and Response (GAR). Available from: Link here. Accessed on 25th June 2013
5. Ajit Sood, Shiv Kumar Sarin, Vandana Midha, Syed Hissar, Neena Sood, Pankaj Bansal et al. Prevalence of hepatitis C virus in a selected geographical area of northern India: a population based survey. Indian J Gastroenterol. 2012; 31(5):232–236.
6. Ashis mukhopadhya. Hepatitis C in India. J. Biosci. 2008;33: 465–473
7. Phukan AC, Sharma SK, Das HK, Mahanta J. HCV activity in an isolated community in north east India. Indian J Pathol Microbiol. 2001 Oct;44(4):403-5. Link here
8. Chelleng PK, Borkakoty BJ, Chetia M, Das HK, Mahanta J. Risk of hepatitis C infection among injection drug users in Mizoram, India. Indian J Med Res. 2008 Nov;128(5):640-6. Link here
9. On the Frontline of Northeast India. Evaluating a Decade of Harm Reduction in Manipur and Nagaland. Translational institute. 2011. Available from: Link here. Accessed on 25th June 2013
10. Chandra M et al. Prevalence, risk factors and genotype distribution of HCV and HBV infection in the tribal population: a community based study in south India. Trop Gastroenterol. 2003 Oct-Dec;24(4):193-5
11. Khaja MN et al. High prevalence of hepatitis C virus infection and genotype distribution among general population, blood donors and risk groups. Infect Genet Evol. 2006 May;6(3):198-204.