There are many myths about the Hepatitis B infection. While some say it is fatal, others believe there is no treatment for the disease. Read on to know the facts.
By Dr Gourdas Choudhari
When 21-year-old Siddharth went to donate blood for his mother’s treatment, he was diagnosed with the Hepatitis B infection during the routine tests. Siddharth was confused. He was fit, played for his college cricket team and had not suffered from jaundice. So, how was it possible?
Hepatitis B is an infection of the liver caused by the Hepatitis B (HBV) virus. Siddharth was lucky to be diagnosed before his liver was damaged; he was put on medications which helped minimise the damage. His mother, who had vomited blood, was diagnosed with liver cirrhosis. Since his younger brother also tested positive, it is likely that both children acquired it from their mother during childbirth.
What makes Hepatitis B worrisome is its silent nature. It can remain undetected for years, sometimes decades, during which the virus attacks the liver cells, leading to liver cirrhosis (severe scarring), liver cancer or liver failure. When symptoms do appear, much of the liver is already badly damaged.
According to global estimates, around 5–10 per cent of the population could harbour the infection. In India, around 3 –4 per cent of apparently healthy people test positive during free check-up camps. The disease spreads by sharing needles with an infected person, poorly-tested transfused blood, sharing of shaving blades, ear-piercing or tattoo needles and from a carrier mother to her newborn during childbirth, etc.,
The screening test for hepatitis B has become a standard recommendation during antenatal checkups. This ensures that a newborn, of a mother, who is a carrier of the HBV virus, can be protected with immediate vaccination and hepatitis B immunoglobulin injections just after birth. Routine vaccination of a newborn.(three shots required for full protection, after one and six months of the first) has now been included in the government vaccination schedule in most parts of India. More than 150 countries, some less economically developed than ours, have adopted it and brought down the infection rates drastically.
The scare around Hepatitis B is largely misplaced. Good and effective treatment in the form of oral tablets is available. These drugs such as entecavir or tenofovir stops the virus from multiplying. Once the virus has been suppressed, usually no further damage occurs to the liver cells. The medications must be continued long-term, often for years.
Myth 1: Hepatitis B is a fatal disease
Fact: Hepatitis B can cause liver failure and even cancer, but it can be fatal if it is not treated. In fact, there are 20 to 40 million infected individuals in India who are living normal lives, and the majority of whom will live till old age. The infection does not kill everyone.
Myth 2: There is no medicine for hepatitis B
Fact: There are around six oral medicines for the treatment of Hepatitis B. The latest medicines are entecavir, tenofovir and TAF (tenofovir alafenamide). These medicines are safe, effective and affordable.
Myth 3: Hepatitis B cannot be controlled
Fact: While there is no cure, the illness can be treated effectively. Only in some individuals, who are infected with the virus, the infection cannot be treated as it has reached an advanced stage. In such cases, the virus injures the liver and can cause liver damage, liver failure or liver cancer, ultimately leading to death.
Myth 4: The vaccine to prevent hepatitis B causes side effects and is costly
Fact: The vaccine for Hepatitis B is a safe and effective method to safeguard one against the disease and has minimum side effects. Additionally, the vaccine used to be costly (approximately Rs 500 for each dose, three such doses were required). Now, it is available for a relatively inexpensive price of Rs 50 per dose.
Myth 5: Hepatitis B spreads by touching, coughing, sharing utensils
Fact: Hepatitis B does not spread simply by the touch of an infected person, by coughing or sharing utensils. In most cases, it is spread only when the body fluids from an infected person enters another through pricking through injections or needles, blood transfusions, etc.
Myth 6: Hepatitis B vaccine should be given to all infected persons
Fact: It is meant for only those who are not yet infected. Anyone who tests positive for HBsAg (also known as the Australia antigen), the surface antigen of the hepatitis B virus (HBV), is not likely to benefit from the vaccine.
Myth 7: Hepatitis B is similar to HIV
Fact: Although both are viruses, they have little in common. Hepatitis B has a vaccine that HIV does not have, is easier to suppress with simple oral drugs and can enable people to live perfectly normal lives.
Hepatitis B is an example of how a timely diagnosis, detection of the virus, evaluation of the need for treatment, effective oral drugs to control the infection and preventing it from spreading can all be achieved effectively.
The author is Director & HOD, Gastroenterology & Hepatobiliary Sciences at a hospital in Gurgaon.
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