Hepatitis (inflammation of the liver) can result from infectious causes and noninfectious causes. Noninfectious causes include alcohol intake, autoimmune conditions, medications etc.

Infection caused by a virus can be called Viral hepatitis. Hepatitis A, Hepatitis B, Hepatitis C and Hepatitis E together contribute to the majority of viral Hepatitis cases.

Viral hepatitis is a public health concern in India. Each kind of Hepatitis poses a different kind of challenge for public health personnel.

In this article we will cover information about Hepatitis B  & Hepatitis C. In the following article, we will cover information about Hepatitis A & Hepatitis E

Hepatitis B

Risk factors

Hepatitis B virus infection is spread by sexual contact with an infected person. Sharing needles by Intravenous drug abusers can result in the spread of infection.

Transmission can happen from infected mother to child.

People who frequently handle blood and blood products like lab technicians, nurses etc. are at increased risk.

Symptoms

Acute infection can go undetected when the person does not have symptoms.

When symptoms are present, they are in the form of

  • Fatigue
  • Loss of appetite
  • Nausea
  • Pain in the abdomen
  • Jaundice

Acute infection usually clears from the body without leading to chronic infection. In some cases, Acute Hepatitis B can continue as chronic Hepatitis Infection.

Chronic Hepatitis B infection can lead to liver cirrhosis (scarring of the liver), liver failure and Liver cancer. About 2 to 4% of people have a carrier state for Hepatitis B, which can lead to scarring of liver.

Diagnosis

Serological tests specific to Hepatitis B can detect the infection and can differentiate acute from chronic infection.

Treatment of Hepatitis B Infection

At present, the available treatment to Hepatitis B is not curative. The goal of treatment at present is to suppress viral replication so that progression to cirrhosis can be delayed.

Discuss with an infectious disease specialist or a gastroenterologist to understand more about treatment.

Prevention

    • Safe sexual practices: knowing the Hepatitis B infection status of the partner & using safe sexual practices (condoms) if you don’t know the health status of your partner can prevent infection with Hepatitis B
    • Safe blood transfusion: The donor blood needs to be tested adequately for Hepatitis B infection before transfusion. In India, blood banks routinely screen blood for Hepatitis B.

 

  • Avoiding sharing of needles

 

  • Screening pregnant women for Hepatitis B: Screening pregnant women for Hepatitis B and taking measures to prevent vertical transmission (transmission from mother to child)
  • Practice caution with Tattooing and body piercing: Insist on disposable needles

Vaccination for Hepatitis B

Hepatitis B vaccine is administered to all infants as part of the universal immunization program.

Adults at risk of getting Hepatitis infection are recommended to get the immunization

  • Partners of people with Hepatitis B
  • People with the chronic liver disease, HIV infection
  • People with IV drug Abuse
  • People with multiple sexual partners
  • Homosexual men

Hepatitis C

Hepatitis C infection occurs when blood contaminated with Hepatitis C comes in contact with an uninfected person.

Acute infection when symptomatic usually presents with fever, jaundice, fatigue. It may go unnoticed too. Body clears infection in some. In others, an acute infection can lead to chronic infection and eventually lead to cirrhosis, Liver failure, and Liver cancer. About 10 to 15% of Chronic liver disease and Hepatocellular carcinoma are associated with Hepatitis C infection in India.

Risk Factors

People who had blood transfusions before Hepatitis screening was a routine practice

IV drug abusers, who share needles

Risky sexual behaviors like having unprotected sex with multiple sexual partners

Mother to child during pregnancy and breastfeeding

Sharing razors, nail clippers

Diagnosis

Serological tests can diagnose acute and chronic Hepatitis C.

Treatment

A cure is possible for Hepatitis C with newer therapies. Discuss with your doctor, preferably with an infectious disease specialist or a gastroenterologist about the available treatments for Hepatitis C.

Prevention

  • Practice safe sexual practices
  • Stay away from IV drug abuse, especially needle sharing
  • Screening during pregnancy can detect Hepatitis C so that measures to prevent transmission can be taken.

Vaccine

At present, there is no vaccine available to prevent Hepatitis C

Awareness about the mode of transmission and taking preventive measures can prevent the spread of infection. Chronic hepatitis can go undiagnosed unless blood tests are done. Testing and detection of chronic Hepatitis B and C could save your life by prevention of long-term complications.

 

-Dr.Lavanya Aribandi, Chief Medical Officer, eKincare

 

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982980/

https://www.researchgate.net/publication/6697645_Viral_Hepatitis_in_India

https://www.medicinenet.com/hepatitis_c_cure_symptoms_and_treatment_costs/article.htm#can_i_drink_alcohol_if_i_have_hepatitis_c

 

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