LAHORE - Every 10th person in the country is suffering from one type of hepatitis or the other and the viral infection varies in severity from a self-limited condition with total recovery to a life-threatening or lifelong disease. Over 20 million people in Pakistan are infected with hepatitis B and C virus including around 15 million with C and five million with B and the disease is swelling at an alarming rate, medical experts say. “Owing to lack of preventive measures and treatment facilities, hepatitis prevalence in Pakistan is the highest on the globe. Every 10th person is infected with hepatitis.
Over 1. 5 lakh hepatitis patients die annually. As such over 400 people are losing life to hepatitis every day. Every year, over 1. 5 lakh Hepatitis patients are added to the existing patient load,” said senior consultant and Principal Gujranwala Medical College Prof Aftab Mohsan. “Preventive measures including infection control at hospitals, proper disposal of clinical waste and regular screening are a key to check spread of hepatitis B and C.By taking all preventive steps and treatment of 2 lakh patients every year, we can control hepatitis in 20 years,” said Prof Aftab Mohsan who has also previously supervised Hepatitis Control Programme in the country.He said that hepatitis control was not on the agenda of international donor agencies while the government lacked resources to curb the menace.Donor agencies are focusing on education, mother and child health, polio eradication and TB control.Government provides treatment to only 20 per cent of hepatitis patients under Hepatitis Control Program and maximum people remain on waiting list due to extra load.
“Tablet Sovaldi is an effective treatment for Hepatitis C. Gilbad Foundation, a charity organization working in the US, is providing tablet for 10 dollars for 50,000 patients in Pakistan.
The actual price of the tablet is 1000 dollars.There is need of bringing this effective treatment in the access of all 20 million patients,” he said.He said that vaccination against hepatitis B was made part of EPI in 2008 which was step in the right direction.He stressed the need for vaccination of babies soon after birth instead of administering in the sixth week.He said that the Punjab has also revised Hepatitis Control Programme and asked for Rs 10 billion allocation for bringing treatment in the access of 50 per cent of the patients.
In Pakistan, an estimated 25 million patients need urgent liver transplantation but most of them cannot afford high cost procedure.Lack of trained surgeons, long queues of patients and strict government regulations regarding blood relation with donors are hindering surgeries in Pakistan.In addition to that high expenses are causing people to go abroad, mostly to India for getting life saving liver transplantation. Many healthcare organisations in Pakistan are offering consultancy for getting liver transplantation from abroad. In the region, India is offering low cost liver transplantation, ranging from Rs 1. 2 million to Rs 3 million depending on condition of the patient and status of the hospital.Main reasons for prevalence of hepatitis are unscreened blood transfusions, reuse of needles and syringes, sharing of needles by drug addicts, use of unsterilised surgical and dental instruments, roadside dentists and barbers, unnecessary or frequent injections and quackery.
High risk groups are drug users, healthcare workers, newborns to hepatitis B infected mothers, household contacts of infected people, persons who frequently use blood or blood products and those having multiple sexual partners and with high-risk sexual behavior. Elderly people and HIV infected persons are also at greater risk of getting Hepatitis. Two main types of hepatitis are prevailing in the country-A and E that usually spread through contaminated water and food and B and C which spread through contact with blood of an infected person and unsafe injection using contaminated syringes. One cannot get infected with hepatitis B or C by shaking hands, coughing or sneezing, using the same toilet, through breast milk, food or water, sharing food or drinks. Symptoms of viral hepatitis are fatigue, nausea, vomiting, loss of appetite, jaundice, abdominal pain, dark urine, bright stools, depression and joint pains.
Both hepatitis B and C are ‘silent viruses’ and as many people feel no symptoms, one could be infected for years without diagnosis. If left untreated, both the hepatitis B and C viruses can lead to liver cirrhosis, accumulation of fluid in the abdominal cavity, bleeding, coma, liver failure and death. Healthy lifestyle is important.People should avoid administration of unnecessary injections, drips, and should follow careful dental treatment, surgeries and use only screened blood for transfusion, avoid roadside dentists and get children vaccinated against Hepatitis B. People should not share toothbrushes, razors, needles, or non-sterilized medical equipment. Hepatitis is a disorder in which viruses or other mechanisms produce inflammation in liver cells, resulting in their injury or destruction.
In most cases this inflammatory process is triggered when the immune system fights off infections caused by viruses. It can also be caused, however, by an overactive immune system that attacks its own liver cells. Inflammation of the liver can also occur from medical problems, drugs, alcoholism, chemicals, and environmental toxins. If damage to the liver is extensive and cell injury occurs beyond the portal tract, chronic active hepatitis can develop. Significant liver damage has usually occurred by this time.Liver cells are destroyed between the portal tract and the central veins in the liver, and progressive cell damage can build a layer of scar tissue over the liver, resulting in the condition known as cirrhosis.In such cases, the entire liver is threatened with malfunction and failure.
