World Hepatitis Day 28th July 2021
Image used for representational purpose only
World hepatitis day is observed every year on 28 th July to raise awareness on Viral hepatitis. July 28 th was chosen as it the birthday of Nobel prize winning scientist, Dr Baruch Bloomberg, who discovered Hepatitis B virus, developed a diagnostic test and effective vaccine for same.
This year's theme given by WHO for World Hepatitis day is "HEPATITIS CAN'T WAIT". Even with the current COVID crisis - a person is dying every 30 seconds from Hepatitis related illness. It is imperative, therefore, not to wait, but act on Viral hepatitis says "Dr. P Anita Reddy,Consultant Gastroenterologist, SLG Hospitals
WHO is aiming to eliminate Viral hepatitis as a public health threat by 2030.
WHO' s - Global Hepatitis Elimination Targets by 2030 include -
Reduce new Viral hepatitis infections by 90 %
Message by WHO for the public on World hepatitis Day :
People with Hepatitis can't wait for life saving treatment
Hepatitis B testing and treatment of pregnant women can't wait
Newborn babies can't wait for their Hepatitis B vaccination at birth
"YOU NEVER APPRECIATE THE FUNCTIONS YOUR LIVER PROVIDES FOR YOU, UNTIL IT STOPS WORKING " - This quote aptly describe how important liver is to overall well being of a person. It is the largest solid organ in the body, comprising about 2 % of adult's body weight and is responsible for a variety of functions that include metabolism, detoxification, digestion, immunity among others.It also ensures well being of every other organ in the body. Therefore, maintaining a healthy liver means maintaining a healthy body.
WHAT IS HEPATITIS ?
Hepatitis is inflammation or damage to liver that can cause severe liver disease or even liver cancer. Damage can be Acute hepatitis ( usually self limiting ), Chronic hepatitis or Cirrhosis ( irreversible damage to liver ) or Liver cancer.
Most common cause of Hepatitis is Viral Hepatitis.
Common causes of viral hepatitis are five hepatotropic viral agents
1. Hepatitis A virus (HAV)
2. Hepatitis B virus (HBV)
3. Hepatitis C virus (HCV)
4. HBV-associated delta agent or hepatitis D virus (HDV) and
5. Hepatitis E virus (HEV)
of these Hepatitis B and Hepatitis C viruses are most common. About 30 % of global disease burden of Hepatitis B and C, is located in South East Asia with an estimated 100 million of Hepatitis B cases and 10 million of Hepatitis C cases. India has intermediate to high endemicity for Hepatitis B with an estimated 40 million cases. Chronic Hepatitis B account for 40 - 50 % of liver cancer cases and 10 - 20 % of cirrhosis cases in India.
Hepatitis B,C,D viruses spread by perinatal route (from infected mother to child ), exposure to infected blood and other body fluids, sexual contact, unsafe injection practices, tattooing, body piercing. Hepatitis A, E are transmitted through ingestion of contaminated food and water. Poor sanitation and unsafe water contribute to spread of these.
HEPATITIS - SYMPTOMS :
Symptoms depend on whether patient has acute hepatitis, chronic hepatitis or cirrhosis. Acute Hepatitis - usually asymptomatic most of the time.
A small subset of patients may develop - jaundice (yellow discoloration of eyes and skin ), dark urine, fatigue, nausea, vomiting, pain abdomen.
A very small percentage of these patients may develop - acute liver failure which may need liver transplantation to save the patient.
Chronic hepatitis - Symptoms will take decades to develop. Most common symptom is fatiguability.
Cirrhosis - is a stage wherein there is irreversible damage to liver. Symptoms include - abdominal and feet swelling due to fluid accumulation, jaundice, bleed from mouth, altered consciousness.
DIAGNOSIS OF HEPATITIS :
The most common clinical consequence of infection with hepatitis A or E virus is acute hepatitis. Large majority of people with acute viral hepatitis recover spontaneously within a few weeks. Infection with HBV, HCV, or HDV too may present as acute hepatitis. However, these viruses have the potential to cause persistent infection in a subset of those infected. Such infection may be associated with ongoing liver damage, which may progress to liver cirrhosis or liver cancer. Many patients are unaware of their Hepatitis disease and are incidentally detected, when blood tests or imaging is done for some other purpose.
1. Blood : A array of blood tests are available for detecting different types of viral hepat LFT- gives information on level of jaundice, degree of liver inflammation and whether patient has acute or chronic Prothrombin time, which estimates blood clotting, Deranged in Acute liver failure as well as in Cirrhos Molecular PCR tests to estimate viral counts in Hepatitis B and C; indicator of viral replication. infectivity and also used for monitoring response to therapy
2. IMAGING : USG abdomen, CT, MRI, FIBROSCAN - give information whether liver is irreversibly damaged or not
3. UPPER GI ENDOSCOPY : Again whether, liver is irreversibly damaged or not
4. LIVER BIOPSY : Biopsy is a procedure wherein needle is inserted into liver and a piece of liver is sent for pathological examination. Usually done when there is a doubt regarding extent of liver damage, or doubt as to what is causing liver damage.
For any disease condition, prevention is often better than cure from both public health and clinical perspective. HAV and HEV are transmitted primarily through contaminated food and water. HBV, HCV, and HDV are transmitted through exposure to contaminated blood or blood components, or use of contaminated needle and syringes. Also a common mode of transmission of HBV infection is from infected pregnant women to their newborns around the time of delivery.
PREVENTION OF VIRAL HEPATITIS INCLUDE FOLLOWING MEASURES :
Mother-to-child HBV transmission can be interrupted through administration of hepatitis B vaccine to newborn babies, beginning with the first dose within 24 hours of birth. If a pregnant woman is known to have HBV infection with high viral load administration of specific hepatitis B immunoglobulin (HBIG) to the baby at birth and/or of oral anti-viral drugs to the mother in the third trimester of pregnancy may provide some additional protHepatitis B vaccine is safe, effective; offers protection against infection in 95 - 100 % of patients. Protection lasts for atleast 20 years and is sometimes lifelong. Therefore booster dose is usually not recommended.
WHO recommends that all infants should be vaccinated as soon as possible, preferably within 24 hours of birth. The scale up of Hepatitis B vaccination programme worldwide over the last 2 decades is a great public health success story. Because of this the proportion of children with Hepatitis B infection has dropped to less tha 1 % in 2019; this was 5 % in pre vaccine era ( 1980's - 2000's )
·Prevention and control of HCV infection :
No vaccine has yet been developed and administration of human immunoglobulin is not effective for prevention of HCV infection. However, marked reduction in HCV transmission rate can be achieved through precautions aimed at interrupting virus transmission. Ensuring safe blood and blood product supply, Use of either disposable or properly sterilized needles and syringes.
Also, Chronic Hepatitis C patients should also receive vaccination against Hepatitis B and Hepatitis A for secondary prevention of these infections.
Disclaimer: Welthi.com does not guarantee any specific results as a result of the procedures mentioned here, and the results may vary from person to person.