Brain treatments made simple
Karachi, Pakistan, May 19, 2010: Hepatitis B virus (HBV) is approximately 30 times more infectious than HIV/AIDS, according to the World Health Organization. While 300 to 350 million people worldwide carry the virus, nearly two million people die from it each year. Dr Wasim Jafri, Consultant Gastroenterologist, AKUH, pointed out that there are approximately five million suspected HBV carriers in Pakistan. Due to the high prevalence of HBV and other forms hepatitis in our country, doctors at Aga Khan University organised a public awareness programme on World Hepatitis Day to increase knowledge about the disease.
The word hepatitis refers to inflammation of the liver. The inflammation is caused by one or more of five viruses: A, B, C, D or E. Dr Amna Subhan, Consultant Gastroenterologist, AKUH, introduced the different types of hepatitis virus to the audience. She said that while hepatitis A, and hepatitis E are water-borne diseases that are transferred by drinking contaminated water or eating unhygienic food; HBV, hepatitis C and D are spread as a result of exposure to infected blood. All these viruses can produce similar symptoms such as dark urine, excessive fatigue, vomiting, abdominal pain and yellowing of the eyes and skin.
Both, hepatitis A and E have almost vanished from the developed world because of improvements in hygiene but they still exist in the developing world. Dr Rustam Khan, Consultant Gastroenterologist, AKUH, said that a patient with hepatitis A or E should take bed rest and avoid medicines that harm the liver such as paracetamol. He pointed out that hospitalisation is only necessary when a patient experiences continuous vomiting or when their jaundice becomes too intense. Vaccines are currently only available for hepatitis A. The easiest way to avoid these two viruses completely is to drink boiled water and eat hygienic food, particularly in the summer and rainy seasons.
In Pakistan, HBV and hepatitis C are transmitted by the reuse blades for shaving by barbers and use of unsterilised syringes for intravenous or muscular injections by physicians; other ways of transmission are using unsterilised instruments for ear piercing and dental treatment. Dr Jafri said that HBV is commonly seen in the children of Asia as it can be passed from an infected mother to a baby at birth. The high number of HBV carriers in Pakistan places an enormous burden on patients, their families as well as on the government and its resources. A large amount of money is spent on treatment of the disease but limited priorities are given to its prevention. Meanwhile, Pakistan has also seen a rise in patients with hepatitis C.
Vaccinations are the best way to prevent HBV. The HBV vaccine provides 100 per cent immunity against the infection. It can be given at any age but it is especially important that every newborn receives it. Dr Jafri added that if a person has HBV, treatment is possible only if diagnosed earlier. Treatment usually includes interferon injections and oral medications. Hepatitis C is curable in almost 80 percent of patients, again only if detected early, and its treatment also consists of a combination of interferon injections and capsules, which are quite expensive.
Speaking about hepatitis D, Dr Khalid Mumtaz, Consultant Gastroenterologist, AKUH said that it is an incomplete virus and cannot cause liver disease unless a patient has HBV. He mentioned that the measures taken to avoid HBV also help avoiding hepatitis D but once hepatitis D develops, treatment becomes extremely difficult.
“A timely diagnosis is essential,” said Dr Rustam Khan, Consultant Gastroenterologist, AKUH. Once the process of cirrhosis, shrinking of liver, sets in, HBV and C become incurable. Dr Khan elaborated the complications of cirrhosis which include: water in abdomen, attacks of unconsciousness, vomiting of blood, and liver cancer. If such conditions develop, a patient should be considered for a liver transplant, which is costly and currently not available in Pakistan.