The Hindu : 'Hepatitis more dangerous than AIDS'

Online edition of India's National Newspaper
Sunday, Nov 23, 2003

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'Hepatitis more dangerous than AIDS'

By Feroze Ahmed

Gastroenterologists (from left) K.R. Palaniswamy, K. Raghuram, Albert J. Czaja and Yogesh Chawla at the annual conference of the Indian Society of Gastroenterology in Chennai on Friday. — Photo: R. Ragu

CHENNAI NOV. 22. Hepatitis is more dangerous than AIDS, said K.R. Palaniswamy, consultant gastroenterologist, Apollo Hospitals, Chennai.

"You can try all therapies but will never know how the body will react. You cannot know if a patient will respond to treatment. AIDS, on the other hand, can be controlled with drugs," explained K. Raghuram, another Chennai-based gastroenterologist.

Albert J. Czaja, Professor, Division of Gastroenterology and Hepatology, Mayo Clinic, Minnesota, USA, added that there was "no vaccine for Hepatitis C and none in the foreseeable future. In fact, in the U.S., only about 50 per cent of those infected with this are treated satisfactorily."

"In India, treatment for Hepatitis C cost about Rs.13,000 a week - or at least Rs. 2 lakhs for a six-month course," added Yogesh Chawla, Professor, Department of Hepatology, Postgraduate Medical Institute, Chandigarh. "Many people have had to sell their land and property to undergo treatment. Yet, they cannot be sure if it will cure them," he said.

In an interview to The Hindu, the four doctors discussed the key forms of liver diseases and why prevention and early detection were perhaps the only safeguards against it. They were participating in the annual conference of the Indian Society of Gastroenterologists.

The commonest liver diseases in India were cirrhosis and cancer, caused mostly by Hepatitis A, B, C and E viruses and alcoholism. According to Dr. Chawla, about two per cent of the Indian population was infected with Hepatitis B - a water-borne virus, and another one per cent with the blood-borne Hepatitis C virus. In terms of population, these percentages translated into huge numbers, he said.

The Hepatitis C virus in India was not as dangerous as its American counterpart. "Most Indians with Hepatitis C virus have genotype 2 or 3 variants, which are very responsive to therapy. But treatment is expensive," he said.

In contrast, Hepatitis B could be managed better, but many did not know it was treatable. Many others were infected with Hepatitis E, another water-borne virus that was peculiar to developing countries such as India and more prevalent during summer and monsoon. The virus could be fatal in pregnant women, he added.

Other common causes of liver diseases were obesity and diabetes. "Junk food, lack of exercise and sedentary habits can lead to deposition of fat in the liver. This will gradually damage the liver and cause cirrhosis after 20 to 25 years," Dr. Chawla said.

While simple lifestyle changes could protect against this form of liver disease, the easiest way to prevent Hepatitis A and B was early vaccination, even immediately after birth.

"It should be a two-stage process. They should screen for the viruses before vaccination. If they are already present, vaccinations will not have effect," said Dr. Raghuram. As for Hepatitis E, the best checks were good, clean water and properly cooked foods.

Common modes of acquiring Hepatitis C were through infected blood, transmitted through blood banks, infected needles, barber nicks, poorly sterilised dental surgeries and even ear-piercing and tattooing. For extreme cases, liver transplants offered some hope. However, it was expensive at Rs.15 to Rs.20 lakhs, and worse, there were few cadaver donors available, said Dr. Palaniswamy.

Another option was to transplant a portion of the liver from another living person, as the organ can grow back to its original size. However, the donor could be at risk of death from post-operative complications. "The risk is minimal, but it is possible that a perfectly normal person can die due to this," Dr. Czaja said.

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