Aug 21, 2012

Deadlier than HIV, Hepatitis B is still a silent epidemic in India


Immediately after former chief minister Vilasrao Deshmukh passed away on August 14 due to complications arising out of liver cancer, the focus shifted to organ donation. His treating doctor, Mohammed Rela, who is considered one of the best liver transplant surgeons in the world, said that he had had a 12-hour window period in which he could have transplanted a healthy liver and kidney to help Deshmukh survive. But without the availability of a cadaveric or brain-dead donor in that crucial period, the chief minister couldn't be saved.
There is no denying that India needs a better cadaver donation programme. The country records less than 500 cadaveric organ donations in a year (most of them occurring in Chennai) even as the number of Indians with organ failure is rising every year.
However, there is another lesson that the Indian authorities need to learn: the serious threat posed by the Hepatitis B virus. It is one of the deadliest but silent epidemics in our country. World Health Organisation's estimates suggest that India is home to 25 to 40 million Hepatitis B-sufferers. Media reports say that the former chief minister, too, suffered from Hepatitis B, an infection brought on by the Hepatitis B virus. In some patients with chronic Hepatitis B infection, the liver becomes cirrhotic; a fraction of these patients may develop liver cancer.
The Hepatitis B virus is 100 times more infectious than the HIV (human immuno-deficiency virus) yet India doesn't have an effective screening programme in the community for this virus. A vaccination programme is available for infants under the national immunization plan, but little is being done to check for the virus among people in the 40-age-group-plus.
In this regard, the Indian government should take a cue from the American Centers for Disease Control's (CDC) latest announcement. CDC last week issued new guidelines advising every baby-boomer (people born after the World War II and before 1965) to undergo one-time blood test to determine if they are carrying the deadly Hepatitis C virus. Once the diagnosis is available, managing the patients - especially the lakhs in India - and preventing liver failure or cancer may be possible.

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