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What is Hepatitis B & C: Top Challenges and Effective Managing Strategies

By Dr. Sanjiv Saigal in Gastroenterology, Hepatology & Endoscopy , Liver Transplant and Biliary Sciences

Aug 01 , 2024 | 2 min read

Hepatitis B and C infections are significant public health challenges worldwide, including in India. These viral infections directly affect the liver and can lead to chronic hepatitis, shrunken liver known as cirrhosis, and even liver cancer. The overall prevalence of Hepatitis B in India is between 2-4%, whereas Hepatitis C prevalence is around 0.5-1.5%.

Both these viruses are transmitted through contact with infected blood or other bodily fluids. These viruses present unique challenges due to their ability to persist in the body for years without causing symptoms, thereby increasing the risk of transmission and delayed diagnosis.

The chronic nature of hepatitis B and C infections can lead to substantial healthcare costs and burden on health systems. Chronic hepatitis B and C infections are major contributors to liver cirrhosis and hepatocellular carcinoma (liver cancer), which may require expensive treatments, including liver transplantation in severe cases.

The pivotal measures in conquering these infections are early diagnosis and prevention. Tests for detecting hepatitis B surface antigen (HBsAg) and hepatitis C antibodies are widely available. Among those infected, it is important to conduct further tests like liver function tests and estimate the viral load by molecular diagnostic tests. Some patients will need imaging studies such as Ultrasound and CT/ MRI scan of the abdomen, endoscopy, and even liver biopsy in selected cases.

It needs to be emphasised that there are now excellent drugs for treatment for both hepatitis B and hepatitis C. These include nucleoside/nucleotide analogues for hepatitis B and direct-acting antiviral (DAA) medications for hepatitis C. Hepatitis C can be completely cured by these highly effective antiviral drugs in the majority when given for 3 months. In comparison, antiviral drugs for hepatitis B can efficiently suppress the virus, reducing the risk of liver damage and associated complications, but the drugs need to be continued for long-term use.

Prevention of these infections should be the focus of our national health policy. As these infections are spread by parenteral exposure to infected blood and body fluids, it is crucial that there should be social awareness about safe practices. These include simple measures such as avoiding sharing razors and toothbrushes, wearing gloves, using disposable needles, being safe during dialysis and blood transfusions, and having safe interpersonal contact. Most importantly, vaccination against hepatitis B is highly effective in preventing new infections, and universal vaccination should be followed. Currently, no vaccine is available for hepatitis C, and hence, preventive measures should be followed. Finally, mother-to-child transmission of hepatitis B can be prevented by vaccination of the newborn and the use of specific immunoglobulin at birth.

Conquering hepatitis B and C infections requires a multifaceted approach encompassing awareness about prevention, early diagnosis, and timely treatment. With continued advances in medical science, newer, highly effective antiviral drugs, efficient vaccination, and judicious resource allocation, the vision of a hepatitis-free world is within reach.

Despite the myriad of challenges, education of masses and social awareness are of paramount importance in conquering Hepatitis B and C infections both in India and globally.