‘Only regular testing can arrest Hepatitis B and prevent liver cancer’

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Eliminating Hepatitis B completely would require ensuring treatment to all those with a chronic infection, preventing transmission from mother to child and immunising children against the infection. Among adults, 95 per cent of Hepatitis B infection clears out and is not chronic. In children, on the other hand, 90 per cent of the infections can be chronic.

One good thing is that now all blood and blood products given to patients are thoroughly screened and so the horizontal transmission (from person to person) has gone down significantly. It is the vertical transmission (from mother to child) that persists.

To prevent transmission, pregnant women must be screened for the infection and put on treatment in the third trimester. And, 100 per cent immunisation must be ensured among newborns.

Other than pregnant mothers, who needs to be treated for Hepatitis B?

People who have Hepatitis B along with jaundice, stage 2 or fibrosis (scarring of the liver and consequent hardening of the tissue) and cirrhosis (later stage of fibrosis where the chronic damage leads to inflammation and fibrous hardening of liver tissue). This is the current recommendation. However, treating all chronic Hepatitis B patients will help in reducing morbidity and the pool of people who can pass on the infection. Patients who already have cirrhosis are at an increased risk of liver cancer even if they have cleared the virus.

What should they do to prevent cancer?

Hepatitis B patients with cirrhosis should get tested every six months to check for cancers. Those with cirrhosis have a one to two per cent risk of developing liver cancer per year, meaning a person who has lived with it for ten years would have 10 to 20 per cent risk of liver cancer.
This is the reason they need to undergo an ultrasound and an Alpha Fetoprotein (tumour marker test).

More importantly, anyone who is already on therapy should not stop it midway without consulting their doctors. This is because a rebound can lead to liver failure and tumours.

What needs to be done to eliminate Hepatitis C?

Eliminating Hepatitis C is easier still; there are cheap and effective treatments that can clear out the infection in 90 per cent cases. They are also freely available under the national programme.

Yet, the infection persists because people do not get tested due to the stigma associated with the disease. Therefore, there is a need to increase awareness. Anyone who underwent surgery or received blood transfusion before 2001 should get tested. All blood samples since are screened for infection.





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