HYDERABAD: Both. Talk about being between the devil and the deep sea. Let us compare the two. Over the last three decades, on an average, viral hepatitis has caused over 1.4 million deaths every year. Currently, there are approximately 400 million people suffering from chronic viral hepatitis worldwide. Although there are five type of viruses that cause hepatitis, just Hep C alone causes more deaths than HIV.
Contrast that to Covid-19. Born in 2019, in just over 18 months, the virus has killed 4 million people and infected 200 million. Almost every country has been affected. A classic biological Hollywood thriller! But ICMR data suggests that over 40 per cent of us in India have antibodies to the virus.
Transmission is the key difference
The key difference between the two is that the transmission (from one human to another) in Covid is via air, breath and hand contact, which is much easier and common than the body fluid transmission that Hep B and C require.
The funny thing is viruses cannot do anything on their own -- they do not respire, feed, excrete or grow; they can’t even move. Many scientists do not even consider them as living creatures. Viruses rely on other living cells to make copies of themselves, thereby killing the host cell. Despite it’s ‘non-living’ status, once within a host cell, it is far from inactive. It loses its protein coat and induces the cell’s own replication machinery to reproduce the virus DNA or RNA, which then assemble to form many more viruses.
The worst part about viral hepatitis is that it isn’t easy to detect. It has few recognisable symptoms, and some people have no symptoms at all. Sometimes, hepatitis starts out with mild flu-like symptoms such as fever, fatigue and body aches. According to the WHO, out of approximately 400 million infected with chronic Hep B or C, 290 million are unaware that they are infected.
Despite the doom-and-gloom picture, my message is one of hope. If you have a history of jaundice, get tested for hepatitis. If you test positive, do not panic. Get treated. In the past, treatment of for Hepatitis C was complex, uncertain and expensive, but now with DAAs (direct acting anti-virals), it is simple, effective and safe.
As far as Hepatitis B is concerned, there has been an effective vaccine for the last 20 years and we must use it. Hepatitis A and E are spread by contaminated food and water, but this can be avoided by following hygienic practices. In case of patients with liver cancer, they can be cured with advanced surgery and chemotherapy, but not if the cancer is in its final stages.
(Prof. Dr. Tom Cherian, is the founder of South Asian Liver Institute, Hyderabad)