Viral hepatitis is a global health problem. The inflammation of the liver caused by the various strains of Hepatitis virus can lead to long term and even life threatening issues.

Hepatitis A affects over one lakh patients every year, including adolescents and adults, besides children. It can keep children out of school and college and adults out of work for several weeks or even months. Relapses can occur. Besides improvements in sanitation and sewage disposal, water and food safety, and health education on hygiene practices, the best way to prevent hepatitis A is through vaccination with the hepatitis A vaccine.

Vaccination is recommended for all children above one year of age and for people at high risk for infection with the virus. Alternatively, prior to taking Hepatitis A vaccine, adolescents and adults can check IgG HAV and if it is positive and in significant titres, vaccine is not required.

The hepatitis A vaccine, which is the inactivated Hep-A virus vaccine, is given as two shots, six months apart. While the primary vaccination protects the person for up to one year, the booster dose administered after six months provides protection for 20 years. The first dose should be given at 12-23 months old, as recommended by the Indian Academy of Paediatrics. Children who are not vaccinated by two years old can be vaccinated at later visits.

Hepatitis B is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness resulting from infection with the Hepatitis B virus.  Hepatitis B is spread when blood, semen, or other body fluid infected with the Hepatitis B virus enters the body of a person who is not infected.

People can become infected with the virus during activities such as birth when it can be spread from an infected mother to her baby during birth, unsafe sex with an infected partner, sharing needles, syringes, or other drug-injection equipment, sharing items such as razors or toothbrushes with an infected person, direct contact with the blood or open sores of an infected person.

The optimum way to prevent Hepatitis B is by getting the Hepatitis B vaccine. The Hepatitis B vaccine is safe and effective and is usually given as 3-4 shots over a six-month period.

Hepatitis B vaccination is recommended for all infants, starting with the first dose of hepatitis B vaccine at birth, all children and adolescents younger than 19 years old who have not been vaccinated, people whose sex partners have hepatitis B, sexually active persons, people who share needles, syringes, or other drug-injection equipment, health care and public safety workers at risk for exposure to blood or blood-contaminated body fluids on the job, people with end-stage renal disease, including those on dialysis, people with chronic liver disease, people with HIV infection, people with diabetes above the age of 19 years, and anyone who wishes to be protected from hepatitis B virus infection.

There is also a combination form, containing both hepatitis A and B vaccine, that can be given to persons 18 years or older. This form is given as three shots, over a period of six months or as three shots over one month and a booster shot at 12 months.

Vaccination is the most practical way of protection against these two forms of hepatitis. Especially with the onset of the monsoon, due to water collection and stagnation, there is a higher risk of Hepatitis A infection. Vaccination enables the development of antibodies and gives long term immunity. So if you are not already vaccinated, now is the time to get yourself protection against the dreaded hepatitis viruses.

Hepatitis C virus is also prevalent world over, and high risk candidates include chronic kidney disease patients undergoing dialysis, persons with multiple sexual partners and drug addicts. Hep C leads to depression, liver cirrhosis, liver cancer and also many extra hepatic diseases which affects the kidney, bone marrow and thyroid. Early stage interventions and new age drugs have proved that treatment is possible.

An alarming change over the years is the identification of Hepatitis E in Kerala – earlier this was restricted to the North part of India. This virus infection that leads to liver inflammation can be critical to pregnant women. Improving sanitation as well as the quality of food and water consumed is the only preventive strategy against Hepatitis E. Much like in Hepatitis A, the need for food safety is the most essential in the prevention of acute hepatitis E, as both viruses can kill the patient due to acute liver failure. 

(The author is a Consultant for Gastroenterology at Aster MIMS-Kozhikode)