Dr. Neeraj Saraf, Senior Director, Hepatology, Medanta – The Medicity, Gurgaon
Hepatitis B and Hepatitis C represent significant global health challenges, characterized by their insidious progression. These viral infections primarily target the liver, a vital organ responsible for numerous metabolic and detoxification processes. A defining characteristic of chronic viral hepatitis is its often asymptomatic nature in early stages, allowing the viruses to inflict progressive hepatic damage over years, or even decades. This chronic inflammation can culminate in severe liver pathologies, including cirrhosis, hepatic failure, and hepatocellular carcinoma. Consequently, diagnosis frequently occurs at advanced stages of liver disease, underscoring the urgent need for proactive strategies.
The Indispensable Role of Regular Liver Monitoring
Given the often-subclinical presentation of chronic viral hepatitis, consistent liver monitoring is paramount, particularly for at-risk populations. This involves routine serological testing to detect the presence of viral markers and biochemical assessments to evaluate liver function. For individuals confirmed to be positive for Hepatitis B or C, ongoing surveillance is critical. This facilitates the tracking of viral activity, assessment of disease progression, and timely initiation of antiviral therapy. Early detection and sustained monitoring are instrumental in preventing disease advancement, enabling prompt intervention, and significantly improving long-term patient outcomes.
India’s Strategic Pathway to Viral Hepatitis Elimination
India bears a substantial burden of viral hepatitis, necessitating a robust national response for its elimination. The country possesses the requisite tools and political will to achieve this ambitious objective.
Key strategic pillars for elimination include:
• Enhanced Screening Initiatives: The foundational step involves widespread and accessible screening programs. Prioritizing high-risk demographics, such as healthcare professionals, recipients of blood transfusions prior to 2002, and individuals with a family history of liver disease, is crucial. Integrating screening into routine healthcare encounters and establishing community-based testing initiatives will facilitate early case identification.
• Universal Hepatitis B Vaccination: Hepatitis B is a vaccine-preventable disease. Universal vaccination of neonates, complemented by catch-up vaccination programs for children and at-risk adults, is essential to establish population-level immunity and interrupt transmission chains.
• Ensuring Treatment Accessibility: For Hepatitis C, highly effective direct-acting antiviral (DAA) regimens offer cure rates exceeding 95%. Ensuring the affordability and widespread availability of these medications through public health procurement and distribution channels is imperative. For Hepatitis B, while a cure is not yet available, effective antiviral therapies can suppress viral replication and prevent disease progression.
• Public Health Awareness and Professional Education: Comprehensive public awareness campaigns are necessary to disseminate accurate information regarding transmission, prevention, and treatment of viral hepatitis. These campaigns should utilize accessible language and diverse media. Concurrently, continuous medical education for healthcare providers is vital to enhance diagnostic acumen and optimize patient management.
• Strengthening Surveillance and Data Management: Robust epidemiological surveillance systems are critical for monitoring disease prevalence, identifying high-burden areas, and evaluating the effectiveness of intervention programs.
Accurate data collection and analysis will inform evidence-based policy decisions and resource allocation.
The elimination of viral hepatitis in India represents not merely a public health aspiration but a critical imperative for national health and economic development. Through concerted efforts involving governmental bodies, healthcare professionals, and community engagement, India can effectively mitigate the burden of these diseases and secure a healthier future for its populace.