Hepatitis is inflammation of the liver. In India Viral Hepatitis is considered a major health issue and currently it is estimated that there are more than 52 million Indians infected with Hepatitis. Majority of the are undetected and undiagnosed making the situation more complicated. The various type sof hepatitis found in India are – Viral Hepatitis, Autoimmune Hepatitis, Alcoholic Hepatitis, Drug Induced Hepatitis And Non-Alcoholic Steatohepatitis (NASH)
It is the leading cause of hepatitis. Almost all cases are caused by one of the 5 viral agents –
Hepatitis A Virus (HAV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Hepatitis D Virus(HDV)
and Hepatitis E Virus (HEV). All types of viruses cause clinically similar illness ranging from
asymptomatic to fulminant infection. HBV, HCV and HDV can cause chronic infections leading
to cirrhosis and hepatocellular carcinoma (HCC).
Hepatitis A :
Mode of transmission is faeco-oral route. People living in overcrowded areas,travelling in HAV endemic areas, i.v. drug abusers, homosexual men are at increased risk of developing the disease.
It can be prevented by maintaining proper hygiene and vaccination. Both passive immunization with IG and active immunization with vaccine is available. IG can be given to unvaccinated persons who had exposure to HAV. HAV vaccine is recommended for use in persons > 1 year age. 2 doses of this vaccine are required.
Hepatitis B :
Modes of transmission are –
Contacts of HBV patients, pregnant women, babies born to HBsAg positive mothers, i.v. drug users, people with multiple sexual partners are at high risk of developing the disease. Active immunization in the form of vaccine should be offered to all newborns and unvaccinated high risk people. 3 doses of vaccine are given. For unvaccinated person sustaining an exposure to HBV, HBIG as well as vaccine should be offered.
Hepatitis D :
Occurs only in people who are already infected with HBV. So, prevention is to prevent HBV infection.
Hepatitis C :
Transmitted predominantly by percutaneous route. Leading cause of chronic viral hepatitis. No vaccine is available for prevention.
Hepatitis E :
Transmitted by faeco-oral route. It can be prevented by maintaining proper hygiene.
It is caused by immune system defect that results in body attacking its own cells. Symptoms are
similar to viral hepatitis. Treatment is steroids and immunosuppressant drugs.
Alcohol is a well known cause of liver diseases. Women are more prone than men. Avoiding
alcohol or drinking in limited amount is the key to prevention.
Drug Induced Hepatitis:
Common drugs implicated are paracetamol, anti-tubercular drugs, anti-epileptics, anabolic
steroids. Giving these drugs in recommended doses and stopping the drugs in cases of liver
injury prevents the development of serious disease.
Obesity, hyperlipidemia and diabetes cause NASH. It can also lead to cirrhosis. Maintaining
ideal body weight, controlled blood glucose levels and regular exercise can reduce the chances