Test.Treat.Hepatitis.

The liver is actually the heaviest internal organ and the largest gland in the human body. Unappreciated and unknown to most of us, an important function of the liver is to produce bio-chemicals necessary for digestion.

And the numero uno enemy of one’s liver is Hepatitis which refers to an inflammatory condition; one of the causes being a viral infection. In India, as per latest World Health Organisation estimates, about 40 million people are chronically infected with Hepatitis B and 6 to 12 million people are chronically infected with Hepatitis C. It must be pointed out that viral hepatitis is a widespread transferable disease caused by the hepatitis viruses A, B, C, D and E. This unfortunate condition can be self-limiting or can further develop into liver fibrosis (scarring), cirrhosis or liver cancer.

Yes. Hepatitis can cause fatalities but the positive aspect is that today it is preventable and to some extent also treatable. There are vaccines available and proper remedial medical intervention can treat the disease and save other people from becoming infected by this highly contagious disease.

Hepatitis and India

The most concerning factor is that in a developing nation such as India wherein awareness levels are low and access to good quality medical intervention even lower – nearly 95 per cent of individuals with chronic hepatitis aren’t aware of their status.

An infected individual can get ill anywhere between 15 days to 6 months post exposure to the deadly viruses. Another frightening aspect is that in many cases, the infection is asymptomatic since infected individuals do not exhibit symptoms and therefore unknowingly become carriers of this deadly virus spurring further infections. There is a possibility of transfusion transmitted infections (TTIs) to ailing patient due to donation of blood by such hepatitis infected individuals. In fact, India faces a unique situation wherein blood shortage for transfusion combined with reports of TTIs could be a challenge for patients to recover. Hence, it is important that patients are reassured in terms of quality of blood to be transfused.

Treatment

As India is vulnerable due to its growing population, it remains under pressure to increasingly implement cutting-edge technologies in transfusion services such as Nucleic acid testing (NAT). Being adopted worldwide, NAT Polymerase Chain Reaction (PCR) testing enables early detection of infections like Hepatitis B & C in donated blood which enhances blood safety. Additionally, voluntary donors have been found to have lower incidence of TTIs than replacement donors.

The serononreactive blood donations are still at risk of transmitting TTIs and thus, need for a sensitive screening test arises to decrease this residual risk which has been reduced significantly over the last two to three decades in countries where NAT has been implemented. The awareness around NAT PCR is increasing in India, however, only about 9 per cent donated blood gets screened by NAT out of 11.6 million blood donations. Unfortunately, NAT is not mandatory in our country for screening of TTIs.

As we observed World Hepatitis Day on July 28, let us all focus on the theme, ‘Test. Treat. Hepatitis’ and lay special emphasis on the important aspect of screening of donated blood to reduce burden of TTIs. This will contribute to WHO global strategy on eliminating Hepatitis B & C by 2030.