CHENNAI: Hepatitis is an inflammation of the liver. There are five main types of the hepatitis virus — A, B, C, D and E. More recently, Hepatitis G has also been identified as a cause of hepatitis not related to those from A to E. Hepatitis B, C and D infections are spread by infected blood products and body fluids. High-risk practices include the use of unscreened blood, sharing needles for injections, tattooing, ear piercing, needle stick injury in health workers and high-risk sexual practices. Hepatitis A and E are transmitted mainly through contaminated food and water.
World Hepatitis Day is observed on July 28 the birth anniversary of Dr Baruch Blumberg, who discovered the Hepatitis B virus, developed the blood test, and the vaccine to raise awareness of the global burden of viral hepatitis and to bring change.
In acute hepatitis, patients present with fever, pain in the abdomen, and loss of appetite and weight. At later stages, the liver is damaged, and the colour of urine, eyes, and skin becomes dark yellow.
Hepatitis can lead to a clinical spectrum of illness — asymptomatic infection, mild febrile illness with jaundice, acute liver failure, chronic hepatitis and cirrhosis, and hepatocellular carcinoma.
Even though Hepatitis B and C may cause no symptoms for years or even decades after infection, the viruses may damage the liver. For this reason, screening is essential for early detection and treatment. It can prevent serious illnesses, such as cirrhosis and liver cancer and limit the spread of infection. Therefore, pregnant women, infants born to HBsAg positive mothers, donors of blood, plasma, organs, tissues or semen, haemodialysis patients before immunosuppression, persons who are HIV positive, healthcare workers with needle stick injury, drug abusers and people with high-risk sexual practices need to be screened.
Prevention is more important than treatment and medication to restrict th deadly diseases. The initial cost-effective screening test is HBsAg for Hepatitis B. Later, it may include Hepatitis B core antibody (Total anti-HBc, IgM) and hepatitis B surface antibody (anti-HBs).
To further evaluate the patient’s infectiveness or assess if recovery has set in, HBeAg and Anti HBe are used, respectively. For Hepatitis C, the screening involves testing for the presence of hepatitis C antibodies. Viral load detection and quantification is required for people proven positive for either Hepatitis B or C to monitor the course of infection.
Neuberg Diagnostics, Chennai, in the last six months, received samples from all over Tamil Nadu and have tested 6,206 samples for HBsAg. Out of which, 148 were HBsAg reactive and 68 samples were newly detected cases of Hepatitis B. For Anti-HCV, we have tested 4,494 samples, 81 were reactive, and 28 samples were newly detected cases of Hepatitis C. By quick and easy screening for Hepatitis B and C, one can protect their family and friends.
Unfortunately, there is no specific treatment for Hepatitis A or E, but fortunately, most infections are self-limiting with supportive treatment. Treatment with antiviral drugs is available for both Hepatitis B and C. In the case of Hepatitis B, with antivirals, the virus’s replication is suppressed; hence, treatment is usually lifelong. In Hepatitis C, however, antivirals can eradicate the virus in most affected people.
The World Health Organization urges all countries to accelerate their efforts to eliminate this threat by 2030. Prevent the disease by following these measures:
(The writer is a senior consultant microbiologist at Neuberg Diagnostics)