Current Scenario of Hepatitis B and Its Treatment in India

Abstract

Hepatitis B is a significant public health problem in India, yet disease awareness is very low among the general population. The disease is mostly acquired horizontally, but the role of vertical transmission should not be underestimated. In spite of the fact that the majority of cases are e negative disease, most patients present in the advanced stage and even with hepatocellular carcinoma, the leading cause of which is hepatitis B. High-risk groups (especially tribals) also harbour significant disease burden and have a high prevalence of occult infection, supporting the potential of unknowingly spreading the disease. Findings on the relation of genotypes with disease severity or drug action have been conflicting. Though recently, oral antivirals with high genetic barrier to resistance have shown good viral suppression in the long term, e and s seroconversion is poor and relapse is universal upon therapy discontinuation. As no cure is possible with the currently available therapy, the target is long-term viral suppression by prolonged administration of oral antivirals; unfortunately, this leads to poor treatment adherence, which along with the high cost of therapy results in disease progression and spread of infection. At present, therefore, emphasis should be put on health education of the general and high-risk populations, along with health care workers to increase knowledge on such preventive measures as avoiding unsafe injection practices, high-risk sex, performing unnecessary injection and blood transfusion and providing proper screening of blood products; these efforts should be combined with intensive screening and aggressive vaccination programs, especially in high-risk groups and areas of high endemicity. Vaccination strategies are still below par and logistics should be developed for wider coverage; in addition, further research should be carried out on the efficacy and mode of usage for different types of vaccine.

Changing Trends of Transfusion Transmissible Infections in Blood Donors in Vidharbha Region: A Retrospective Study of Thirteen Years

“…7 NACP phase IV (2012-2017) is acclaimed globally as one of the most successful programs which included prevention, care, support and treatment services. 6 In our study the rate of HIV infected donors was 1.10% to 21 The seropositivity for HBV in our study was 1.99% in 2005 which showed a gradual declining trend through1.86% in 2008,1.49% in 2012 and0.97% in 2017. Our study correlates with Sastry J et al 17 which showed a declining trend from 1.89% in2008 to 0.63%in 2013, Mohan Raut 14 reported 2.55% in 2005 and 1.64% in 2011.…”

Adolescent Immunization Schedule: Need for a Relook

“…Hepatitis B vaccine: India is now considered among the category of intermediate endemicity for hepatitis B and its prevalence is found to be 2-7%, with an average of 4% [26]. Although the predominant mode of transmission of hepatitis B in India is horizontal, perinatal transmission through mother to child is also not insignificant.…”

A Rare Case of Hepatic Sarcoidosis Caused By Hepatitis B Virus and Treatment-Induced Opportunistic Infection

“…In the United States, the lifetime risk of sarcoidosis in black patients is 2.4% as compared with a lifetime risk of 0.85 percent in white patients. In India, the prevalence of HBV is 2% to 7%, with an average of 4%, with a burden of approximately 50 million people with chronicity [2][3][4][5][6].…”