Why is hepatitis called the silent killer?

Dr Roy Patankar, leading Gastroenterologist & Director of Zen Hospital sheds some light on this condition

Did you know hepatitis kills millions of people every year, and most of these deaths are due to lack of knowledge? We spoke to Dr Roy Patankar, leading Gastroenterologist & Director of Zen Hospital to know more about hepatitis and why it is called the silent killer.

Deaths due to hepatitis are on the rise, is there a specific reason?

The World Health Organization (WHO) estimates that in India 40 million people are chronically infected with hepatitis B and around 6 to 12 million people are chronically infected with hepatitis C. It is estimated that only 5 per cent of people with chronic hepatitis know of their infection and less than 1 per cent have access to treatment. So, you know why the numbers are increasing and we need awareness programs to prevent these deaths.

Are all kinds of hepatitis deadly?

The term hepatitis refers to inflammation of the liver happening secondary to either viruses or excessive accumulation of fat in the liver. Hepatitis is categorized into five main types depending on the viral agent causing the disease. These five types of hepatitis are currently of the greatest concern all over the world because they account for a huge burden of illness, outbreaks and epidemic spread, resulting in increased death cases which are preventable.

Among the five types, Hepatitis A and E spread through contaminated water or food through feco-oral route, whereas Hep B and C are through body fluid, semen, blood and unsafe sex practices. Hepatitis D is always associated with Hepatitis B.

HAV and HEV infections are usually mild and patients can fully recover, but in some cases HAV infections can be potentially severe as well as life-threatening requiring emergency liver transplant as treatment of choice. Most people living in poor hygienic conditions are more prone to acquire the virus.

Hepatitis B and Hepatitis C are caused by exposure to infected blood transfusion, contaminated blood and blood products, usage of contaminated injection during medical procedures and through injected drugs. Hepatitis D occurs only in people who are already infected with HBV. Infection of HDV and HBV together can be extremely serious and may result in the worse outcome. Hepatitis D vaccine is not available, but it can be prevented in people who are not already HBV-infected by hepatitis B vaccination.

What are the symptoms associated with these conditions?

In general, symptoms associated with hepatitis of any cause are jaundice, yellowing of the skin and eyes, dark-coloured urine, extreme fatigue, nausea, stomach pain and bloating, itching, loss of appetite.

How are the conditions treated?

Based on symptoms, one should undergo a few tests like the liver function test and blood test. When the liver cells get damaged, liver enzymes get released into the bloodstream which serves as a marker to diagnose hepatitis. Next, the ultrasound of the abdomen is done. Ultrasound uses sound waves to produce an image of the abdomen. It enables the doctor to visualize the size and structure of the liver. It also helps in evaluating jaundice or abnormal liver function test. It also shows the presence of solid mass, cyst or a tumour in the liver. A treatment is suggested accordingly. However, apart from infections, another major cause of hepatitis is excessive fat accumulation in the liver.

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