Hepatitis B is an infection of the liver that is caused by the hepatitis B virus (HBV). India has the world’s second-highest prevalence of viral hepatitis cases, according to the latest World Health Organisation (WHO) report.
While hepatitis A and E cause an acute form of the disease, hepatitis B and C lead to chronic liver disease including cirrhosis and even liver cancer.
On World Liver Day, April 19, here’s understanding more about Hepatitis B, which affects more than one lakh people in India every year.
Dr Bhaskar Nandi, HOD, Gastroenterology, Amrita Hospital, Faridabad, said that in India, horizontal transmission accounts for over 60% of cases, and vertical transmission from mother to newborn are predominant modes of HBV infection in India.
“Other significant transmission routes include unsafe injection practices, IV drug abuse, tattooing, and high-risk sexual behaviour. Tribals, HBV patient contacts, dialysis patients, professional blood donors, IV drug users, and individuals with risky sexual behaviour are at elevated risk,” said Dr Nandi.
HBV is spread by contact with the blood or body fluids of an infected person, the same way as the human immunodeficiency virus (HIV), according to the WHO.
However, HBV is 50 to 100 times more infectious than HIV.
“HBV infection often remains silent for years before manifesting as cirrhosis or complications like jaundice, ascites, variceal bleeding, or liver failure,” added Dr Nandi.
Chronic HBV infection contributes to over half of liver cancer cases and a significant number of annual liver-related deaths.
There are many challenges in prevention of hepatitis B as it is a silent and highly infective virus.
In India, the infection is generally acquired in childhood and subsequent diagnosis and treatment requires specialised centres with trained staff or medical health workers.
For protection against HBV infection, periodic testing, universal vaccination, safe practices, and public health initiatives to increase awareness and access to screening and treatment facilities are required.
Meanwhile, in children, Hepatitis A virus (HAV) infection is the primary cause of liver disease in India.
It ranges from mild to severe acute liver failure. HAV accounts for 70 to 80% of acute viral hepatitis and 40 to 60% of liver failure cases in Indian children.
HAV and Hepatitis E (HEV) are RNA viruses transmitted through contaminated food or water, leading to acute hepatitis, particularly during monsoon seasons.
Outbreaks are common in states like Kerala, Tamil Nadu, Himachal Pradesh, and Maharashtra.
While HEV positivity increases with age, both viruses require supportive treatment, with liver transplantation as the only option for acute liver failure.
Dr Arti Pawaria, Clinical Lead and Senior Consultant, Pediatric Hepatology and Gastroenterology, Amrita Hospital, Faridabad said, “Management of bleeding and cerebro-protection is crucial, with liver transplantation being necessary in cases with irreversible liver failure. All children with acute liver failure require urgent hospitalisation.”
Preventive measures include vaccination against HAV and Hepatitis B (HBV), along with hygienic practices like regular handwashing and safe food and water consumption, and improving sanitation practices for sewage disposal.
The Hepatitis A vaccine offers long-term immunity, while efforts are ongoing to develop a vaccine for Hepatitis E.
Hepatitis B infection accounts for a third of all chronic liver diseases and over 50% of al liver cancer patients in India. Hepatitis A accounts to a majority of all acute liver failure in India, the experts said.
These initiatives are crucial in combating the global mortality caused by hepatitis and ensuring public health safety through awareness, vaccination, and access to healthcare services.
Rohit Malhotra is a medical expert and health journalist who offers evidence-based advice on fitness, nutrition, and mental well-being. His articles aim to help readers lead healthier lives.
