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• NEARLY 40 MILLION PEOPLE IN INDIA SUFFER FROM HEPATITIS B
• YOU CAN CARRY THE VIRUS EVEN WITHOUT KNOWING IT.
• IT’S EVEN MORE INFECTIOUS THAN HIV
• IT ATTACKS THE LIVER LEADING TO CIRRHOSIS, LIVER CANCER AND EVEN DEATH.
• IT CAN BE PREVENTED BY SIMPLE VACCINATIONS.

Liver the master organ in our body deals with carbohydrates, proteins and fat metabolism. It stores the energy and supplies it to the rest of the body, as and when required. In addition to above functions it also helps to destroy some of the waste products and toxic substances. Unfortunately, the liver can be attacked and damaged by many organisms like bacteria and virus. For example, Hepatitis A and Hepatitis E are viruses that spread through consumption of unclean water or unhygienic food. These viruses attack the liver resulting in fever, yellow skin (jaundice), dark urine and tiredness. Liver being a clever organ destroys these organisms. However, in some patients with low immunity (such as elderly, pregnant women) these viral infections may lead to life threatening liver failure. Interestingly, this virus does not cause any long-term damage to the liver. Hence, it is important to drink clean water and eat healthy food to avoid these infections.

Hepatitis B virus

Hepatitis B is also a virus like Hepatitis A that affects the liver. As per WHO estimate, nearly

• 40 million people in India carry Hepatitis B virus.
• 100 times more infectious than HIV.

Hepatitis B spreads by blood products:

• Un-sterile needles,
• Un-screened blood,
• Mother to baby
• Un-protected sex
• But not by water or food.

In India, the common mode of transmission is from mother to baby. Nearly 30% of the affected children develop cirrhosis, the end stage liver disease, over a span of 20 to 40 years. The virus behaves differently depending on the age of acquisition. Hepatitis B virus is very strong particularly in children, that the liver fails to clear it in 95% of cases and it stays inside the body for many years without causing any symptoms. Ninety five (95%) percent of patients who acquire Hepatitis B at adulthood clear the virus with minor illness. In those who fail to clear, the virus stays inside the liver and continues to multiply. This process happens over several years resulting in liver injury. In some patients the virus remains dormant without causing any damage and they are described as ‘carriers’. In those with active viral multiplication there may not be any symptoms, until a point where the liver fails to carry out its functions in one third of patients. Progressive damage results in scar formation; liver tries to combat the injury and tries to grow. Hence the damaged liver becomes shrunken with areas of regeneration. This is called ‘cirrhosis’. This is a very dangerous condition that is commonly seen in our country. Some patients with cirrhosis may suffer from lack of energy but most of them may not have any symptom until complications of cirrhosis develop. Yellow discoloration of the skin, vomit blood, big belly, and altered sleep pattern are some of the symptoms of complications of cirrhosis. Once these complications develop the patient survival is considerably reduced. In severe cirrhosis the 1-year survival is reduced to almost 30%. Over 1 lakh Indians die from Hepatitis B related illness each year. Hepatitis B infection can be controlled if treated early. There are effective drugs these days to treat Hepatitis B infection. If detected and treated early the complications can be averted.

Liver Cancer

Liver cancer is the worst complication of cirrhosis. Worldwide including India, Hepatitis B infection is the commonest cause of liver cancer. A unique feature of Hepatitis B related liver cancer is that the virus causes cancer directly even before progressing to cirrhosis. Once the cancer occurs, patients’ health and immunity reduces drastically, making them prone for infection and spread of the cancer. They may suffer from poor appetite and weight loss. Eventually the cancer spreads within the liver and to other parts of the body, resulting in death. Early cancers do not cause any symptoms. But, if detected early this cancer can be cured various modalities including liver transplantation.

Hepatitis B infection can be prevented by vaccination

For all the above reasons it is important to do routine tests for Hepatitis B virus infection. Interestingly, Hepatitis B infection can be prevented by vaccination. This prevents not only from the infection but also from cirrhosis and liver cancer. World Health Organization recommends ‘universal vaccination’ against Hepatitis B virus infection, in particular for high-risk patients such as pregnant women or anyone from Asia or Africa.

Similar to Hepatitis B, Hepatitis C virus also spreads through inadequately screened blood or related products and use of unsterilized needles e.g., intravenous drug abusers, re-use of needles and razors from affected person. Once again, this virus stays inside the liver for many decades without causing any symptoms. . The liver does not clear the virus and continuous damage occur leading to cirrhosis in one third of patients. Interestingly, Hepatitis C can be cured in 40-80% of patients if detected early when the damage is less. Newly developed drugs in combination with the older ones increase the cure rate from 70 to 90%. Unfortunately, the injections are expensive and may not be affordable by everyone. However, clearing the virus at the earlier stage prevents the development of cirrhosis. Once the cirrhosis is prevented, there is no risk of liver cancer due to Hepatitis C virus. In the Western world, Hepatitis C related cirrhosis is a leading indication for liver transplantation. Unlike Hepatitis B, there is no vaccine to prevent Hepatitis C infection.

According to the World Health Organization, 1 in 12 people carry either Hepatitis B or Hepatitis C virus and may be more in some countries. Suspected high-risk individuals must be checked for the presence of these viruses. If positive, further tests should be carried out to assess disease severity and the degree of liver damage. A liver specialist (Hepatologist) consultation should be obtained for further management.

World Hepatitis Day

WHO has announced 28th July 2011 as World Hepatitis Day to create awareness about liver diseases and preventive strategies. To join hands with WHO, MIOT Hospitals is pleased to announce the commencement of ‘Live for Life’ yellow ribbon campaign against liver diseases, particularly against Hepatitis B infection. MIOT Hospitals is happy to announce that the most popular South Indian Film Star and The Youth Envoy – UN Habitat DR. VIKRAM will inaugurate the World Hepatitis Day campaign on 31st July 2011. On this day, Hepatitis B screening followed by first vaccination dose will be carried out for free of cost. Not just that dose, the complete course of Hepatitis B vaccination worth Rs 1697/- will be given free.

Remember, liver cirrhosis is caused not just by viruses but also by excess alcohol, fat and other rare diseases. Presence of these additional factors accelerates the liver damage leading to cirrhosis and death at much younger age!

MIOT Advanced Center for Gastrointestinal and Liver diseases provides solution for all gastrointestinal and liver disorders. We have state of the art endoscopy unit with all latest technology including ‘spy-glass’ endoscopy to look into the bile duct. Top notch specialists trained in India and abroad are available for managing complex gastrointestinal and liver disorders. Provision of best care for all our patients is our ultimate goal at the MIOT Advanced Center for Gastrointestinal and Liver diseases unit.