Viral hepatitis, a viral infection of the liver, is a global health problem affecting all age groups and people from all walks of life. In most of the cases, the disease is self-limiting but occasionally, it can lead to serious complications. Prof. Shiv K. Sarin, Director of the Institute had way back in the late nineteen nineties, realized the need for generating awareness on hepatitis due to viruses transmitted through blood transfusions and consequences of chronic viral hepatitis (commonly caused due to hepatitis B and C). To meet these objectives, single theme consensus conferences were held in New Delhi in February and December 1996, in December 1998 and September 2000. On 4th December 1998, Dr Sarin championed and launched a mass awareness drive against the menace of hepatitis as the First Yellow Ribbon Campaign in the country. The color “Yellow” was chosen as it represented the color of Jaundice – the most ubiquitous and conspicuous symptom of liver disease.
Continuing the battle against this menace, G. B. Pant Hospital, New Delhi celebrated “The Hepatitis Awareness Day” on December 4, 1999 and December 4, 2000 under the stewardship of Dr Sarin, who was then the Director and Head, Department of Gastroenterology. In the year 2001 the Govt. of NCT of Delhi declared 4th of December as the official Hepatitis Day for the state of Delhi. Ever since the inauguration of ILBS in 2010, it has been mandated by the GNCTD as the nodal agency for organizing Hepatitis Day function in Delhi. Our focus, however, remains the same – creating awareness in the general public, especially school children and high-risk groups about proper hygiene, safe water supply, safe sexual practices, safe and screened blood transfusions and vaccination to prevent hepatitis.
Various means of imparting knowledge are used – ranging from poster competitions to family counseling sessions. Poster exhibitions have been organized since the first Hepatitis Day wherein school students, nurses, health-care workers and medical students display colorful and imaginative posters describing the modes of transmission, prevention and treatment of hepatitis for public awareness. Public lectures by eminent celebrities and public figures are organized to sensitize the audience about Hepatitis and the dangers it represents. Free blood screening camps are also organized to detect Hepatitis infection in walk in patients.
Hepatitis – what it is and how to avoid it
The common viruses which infect the liver are Hepatitis A, B, C and E. Of these Hepatitis A and E are transmitted through contaminated food and water and may take the form of an epidemic. These are self limited infections and the patient recovers on his own without any specific treatment over 4-8 weeks. In a small proportion (<1%) the infection may result in a more serious form of the disease leading to rapid deterioration in health and even death especially in pregnant females. Hepatitis A and E infections can be prevented by using safe water and hygienic food.
Blood-borne viruses (Hepatitis B and C) are transmitted by transfusion of infected blood, by use of infected needles, by unprotected sex and from infected mother to child. In some patients, the infection can become chronic i.e. the virus persists in the body. In the case of Hepatitis B virus, only 5-10% patients become chronic carriers but if the infection occurs during childhood, the patient becomes a chronic carrier in 60 to 90% of cases. Hepatitis C on the other hand, is like an emerging global epidemic; of those who get infected, about 80% remain chronically infected. The important consequences of chronic infection are chronic hepatitis, cirrhosis of liver and even liver cancer. About 20-30% of those with chronic infection ultimately develop liver cirrhosis and cancer. There is a vaccine available for prevention of hepatitis B while for Hepatitis C, there is no vaccine. Hence, a very high level of awareness and preventive efforts including ‘safe blood’ transfusion is needed to protect against Hepatitis C.
Myths related to Hepatitis
There exist many misconceptions regarding the entity “viral hepatitis”. First, the occurrence of jaundice as a symptom in a person is not synonymous with viral hepatitis, though the latter may be the commonest cause of jaundice in the community at large. Secondly, no specific therapy can shorten or modify the course of an acute attack of viral hepatitis; rather commonly prescribed indigenous drugs may actually be detrimental. Third, strict dietary restrictions are imposed by members of the family on the patient of acute viral hepatitis, which are of no proven benefit. Most of these restrictions are unwarranted and injudicious and may hamper recovery of these patients. The sick liver needs energy, which can be supplied only through good nutrition.
Protection against Hepatitis
The old adage of "prevention is better than cure" is very apt for viral hepatitis. General sanitary measures like safe drinking water, avoidance of use of common razors/toothbrushes with patients of liver disease, use of sterile needles and syringes, practicing safe sex can prevent the transmission of hepatitis viruses. For prevention of Hepatitis B, safe and extremely effective vaccines are available. 95% of those individuals who receive vaccination develop long term immunity against these viruses. There is also an urgent need to enforce better standards of screening for blood/blood products as well as good clinical practice with respect to surgical and dental procedures.