Hepatitis refers to an inflammation of the liver, a vital organ that performs hundreds of essential functions, including filtering toxins, producing proteins, and aiding digestion. When the liver is damaged by hepatitis, these functions are compromised. Viral hepatitis is caused by various viruses, predominantly hepatitis A, B, C, and E.
July 28 is being marked as World Hepatitis Day in a bid to call for action to end this entirely preventable disease.
Hepatitis A and E are spread through contaminated food and water and infection with these viruses causes acute onset jaundice, which is usually self-limiting but can sometimes progress to acute liver failure, which is potentially life-threatening. On the other hand, hepatitis B and C viruses (HBV and HBC) are spread through infected blood or body fluid exposure, including unsafe sexual and injection practices. They usually cause chronic long-term infections. Hepatitis B and C are silent killers that damage the liver over many years, leading to serious conditions like cirrhosis (scarring of the liver), end-stage liver disease, and even cancer.
At the outpatient liver clinic at the PGIMER, around 800-1,000 patients with chronic viral hepatitis (HBV and HCV) are seen each year, Ajay Duseja, head, Department of Hepatology. PGIMER, said. The expert added that Punjab is a high burden state for hepatitis C, possibly due to intravenous drug abuse.
Punjab has been at the forefront of the fight against hepatitis C, and its approach of decentralising diagnosis and treatment using a hub and spoke ECHO model has been replicated not only nationally but has garnered much international attention, Dr Sunil Taneja, additional professor, PGIMER, said.
A new observation over the last few years is the increase in numbers and severity of hepatitis A virus infection. Almost half of the acute liver failure patients admitted to the Liver ICU in the last 2 years have been due to Hepatitis A, which is a cause for concern, Dr Madhumita Premkumar, additional professor, Department of Hepatology, PGIMER, said.
Hepatitis A has also been presenting atypically, particularly with prolonged jaundice and itching, which may require steroids and even plasma exchange, Dr Nipun Verma, additional professor, Department of Hepatology, PGIMER, said.
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Dr Arka De, associate professor, PGIMER, said viral hepatitis is largely preventable, with hepatitis A and B vaccines safe and effective, and newborns should receive the hepatitis B vaccine within 24 hours of birth to prevent transmission from mother to child.
Safety First
Wash your hands after using the restroom and before preparing food. Hepatitis A and E are often spread through contaminated water and food. Ensure that food is properly cooked. Drinking water should be filtered or adequately boiled. Eatables should be kept covered and away from flies.
Avoid intravenous drug abuse, use sterile needles and do not share them. Safe piercings and tattoos are vital, ensure new, sterilised needles, razors and equipment during tattoos, shaving and piercings.
Practice safe sex
The crucial need for testing — Dr Arka stressed that testing is the only way to know if you are infected since chronic hepatitis often has no early symptoms in the initial stages. Early diagnosis is key because it allows for timely treatment, which can prevent severe liver damage and save lives. If you have a history of blood transfusions, injecting drug use, or a family history of hepatitis, or if you are pregnant, it is highly recommended to get tested, according to the expert.
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The National Viral Hepatitis Control Program (NVHCP), offers free services for diagnosis and treatment of viral hepatitis patients informed Dr Naveen Bhagat, assistant professor, PGIMER. He added that in Chandigarh and Punjab, free testing and treatment for hepatitis B and C are available at government health facilities, including the PGIMER, and excellent cure rates have been seen with these treatments.
