The Hindu : Tamil Nadu News : Infants face hepatitis threat from mothers

Online edition of India's National Newspaper
Monday, Apr 18, 2005

Tamil Nadu

Tamil Nadu

Infants face hepatitis threat from mothers

M. Dinesh Varma

Over 1 million babies run risk of chronic HBV infection Screening of pregnant mothers and newborns, followed by immunisation, alone can stop the spread of the Hepatitis B virus, say experts.

CHENNAI: : In the absence of uniform peri-natal screening programmes or immunisation cover, infants are still at the risk of contracting Hepatitis B from infected mothers, say doctors.

Vertical transmission, from infected mother to child, is a common mode of transmission of the Hepatitis B Virus (HBV), besides blood transfusion and unprotected sex.

Though there is scant data on HBV prevalence, according to an estimate, of the 25 million infants born every year in the country, over 1 million run the lifetime risk of chronic HBV infection, says T. S. Chandrasekar, interventional gastroenterologist, and founder-chairman, MEDINDIA Hospitals.

India, classified in the intermediate endemicity zone, is estimated to have 42 million HBV carriers.

Project Yellow

Based on the findings from three years of antenatal screening programmes, MEDINDIA puts the average prevalence of HBV in Chennai at 3.5 per cent. The hospital plans to launch Project Yellow to evaluate prevalence in a larger population sample and the modes of infection, and to plan measures to identify early cases and treat them.

Surgeons at the Government Royapettah Hospital point out that the `silent' nature of the infection (patients do not exhibit symptoms) can confound any effort for a quantitative assessment of the problem. And, unlike in the case of blood transfusion, screening of pregnant mothers is not done in all peripheral hospitals.

In cases of HBV manifesting, the patient suffers from fatigue, loss of appetite, vomiting, nausea, yellowing of skin and joint pain.

Estimates indicate that annually over 100,000 Indians die because of illness related to Hepatitis B infection.

These chronically infected persons are at a high risk of mortality from cirrhosis and liver cancer, which together account for one million lives a year. Around one per cent of chronic patients die from fulminant liver failure.

`Immunisation vital'

These figures form the basis of the argument for including the Hepatitis B vaccine in the Universal Immunisation Programme as opposed to the policy of selective, high-risk vaccination, feel doctors.

The Indian Association for the Study of Liver, which has put the latest average HBV prevalence in the country at 4.7 per cent, is the latest professional body to recommend universal immunisation for Hepatitis B, which can provide 95 per cent protection.

Dr. Chandrasekar says prompt administering of Hepatitis B immuno-globulin and the first dose of HBV vaccine within 12 hours of birth have been shown to effectively protect the babies of carrier mothers.

An alarming aspect of the HBV is its high infectivity, several times more than that of HIV.

However, a comforting feature of HBV is that some patients are able to eradicate the virus from their system through natural process, say gastroenterologists.

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