Hepatitis means inflammation of the liver. This condition is often caused by a virus. In India, the most common causes of viral hepatitis are hepatitis B virus (HBV) and hepatitis C virus (HCV). As HBV and HCV can be spread in the same ways as HIV, people with HIV in India are often also affected by acute or chronic viral hepatitis.
Viral hepatitis progresses faster and causes more liver-related health problems like liver cirrhosis, liver cancer, and end-stage liver disease among people with HIV than among those who do not have HIV. Liver disease, much of which is related to HBV or HCV, is a major cause of non-AIDS-related deaths among people with HIV.
Interview: Dr. Bodda Venkata Sriram, Associate Consultant, Medical Gastroenterology, Manipal Hospital, Goa
Q: How do Hepatitis B and C spread?
Like HIV, the hepatitis B and hepatitis C viruses are spread:
* By sharing needles, syringes, and other equipment used to prepare and inject drugs.
* Perinatally: Pregnant people can pass these infections to their infants. Having HIV and HCV coinfection or HIV and HBV coinfection increases the risk of passing HCV or HBV to the baby.
* Sexually: Both viruses can also be transmitted sexually, but HBV is much more likely to be transmitted than HCV. Sexual transmission of HCV is most likely to happen during anal intercourse among men, who have sex with men, particularly for the receptive partner.
Q: How can you prevent Hepatitis B and Hepatitis C?
Hepatitis B: Vaccination is the best way to prevent it. People with HIV who do not have active HBV infection should be vaccinated against it. The hepatitis B vaccine is now recommended for all infants, children and adults ages 19-59, as well as adults above 60 years of age, who are at high risk for infection. There is a 3-dose series of hepatitis B vaccine given over 6 months and a 2-dose series given over a month. Additionally, there is a combination vaccine called Twinrix that protects against both hepatitis A and hepatitis B.
Hepatitis C: No vaccine exists for HCV and no effective pre or post-exposure prophylaxis is available. Injection drug use is one of the risk factors for hepatitis C. For people who inject drugs, the best way to prevent hepatitis C infection is to always use new, sterile needles or syringes, and never reuse or share needles or syringes, water, or other drug preparation equipment.
Community-based prevention programs, such as medication-assisted treatment (MAT) and syringe services programs (SSPs) provide support and services aimed at preventing and reducing the transmission of HCV. Although the risk of sexual transmission of HCV is considered to be low, avoiding unprotected sexual exposure by using condoms has been shown to reduce the chance of STDs.
Q: How many people are infected yearly?
About 257 million people are infected with chronic hepatitis B (CHB) globally, resulting in 887,000 deaths annually. More than 90% of the deaths and disability as a result of viral hepatitis can be attributed to CHB and chronic hepatitis C infections.
