0.35 CME

हेपेटाइटिस बी और सी: अवलोकन

वक्ता: डॉ. उदय सांगलोडकर

वरिष्ठ सलाहकार - हेपेटोलॉजी और लिवर ट्रांसप्लांट ग्लोबल हॉस्पिटल, मुंबई

लॉगिन करें प्रारंभ करें

विवरण

Hepatitis B and C are two distinct viral infections that affect the liver, causing a range of liver-related diseases. Hepatitis B is primarily transmitted through exposure to infected blood and other bodily fluids. It can be acute or chronic, with chronic infections posing a higher risk of liver cirrhosis and liver cancer.Hepatitis C is caused by the hepatitis C virus, typically transmitted through blood-to-blood contact. Chronic HCV infection can also lead to liver cirrhosis and liver cancer. Both HBV and HCV can be asymptomatic or present with similar symptoms, including jaundice, fatigue, and abdominal discomfort. HBV can be transmitted from an infected mother to her baby during childbirth, through sexual contact, and sharing needles. HCV is primarily spread through sharing needles, contaminated medical equipment, or in rare cases, sexual contact. Both diseases are global health concerns. HBV is more common in regions like Asia and Africa, while HCV is more prevalent in some parts of the United States and Europe. There is an effective vaccine for HBV that has significantly reduced new infections. No vaccine for HCV exists, but direct-acting antiviral drugs have revolutionized HCV treatment. Chronic hepatitis B can be managed with antiviral medications, while hepatitis C can be cured with a combination of antiviral drugs.

सारांश

  • Dr. UD SAR, a consultant hepatologist, discusses Hepatitis B (HBV) and Hepatitis C (HCV) infections, emphasizing awareness and treatment. HBV and HCV are hypotropic viruses, primarily affecting the liver. Unlike Hepatitis A and E, which are acute and self-limiting, HBV and HCV cause chronic infections. India's HBV prevalence is 2-3% of the population, higher than HCV at 1%.
  • HBV and HCV transmission occurs through direct blood contact, mother-to-child transmission, unsterilized equipment (tattooing, piercing), IV drug use, and household contact. While breastfeeding is generally safe, healthcare settings present risks of transmission through needle stick injuries and infected fluids. HBV is more infectious than HCV and HIV, with HBV and HIV co-infection being especially concerning.
  • The damage to the liver is primarily due to the body's immune response, not the virus itself. A strong immune response can clear the virus, while a weak response leads to chronic infection. Over-stimulation of the immune system, however, can cause acute liver failure. Infants and immunocompromised individuals are particularly susceptible to chronic infections.
  • HBV infection often presents as a chronic inactive carrier state. If the virus is still present, 20-50% can develop cirrhosis, leading to HCC and death. Clinical presentations vary from asymptomatic to decompensated cirrhosis or HCC. Diagnosis involves history, physical examination, blood tests (including HBV DNA quantification), ultrasound, fibroscan or mography.
  • HBV infection is not curable, but antiviral medications like entecavir, tenofovir, and tenofovir alafenamide can control the virus. Vaccination is crucial for prevention, especially for healthcare workers. Post-exposure management involves immunoglobulin and vaccination based on vaccination status and anti-HBs titer levels.
  • HCV infection often leads to chronic infection, with a smaller percentage clearing it spontaneously. Cirrhosis can develop after 20 years. Diagnostic protocols are similar to HBV, including HCV RNA quantification. HCV is curable with direct-acting antivirals (DAAs) like sofosbuvir and velpatasvir, irrespective of cirrhosis status.
  • HCV treatment duration depends on the presence and severity of cirrhosis, ranging from 12 weeks to 24 weeks with or without ribavirin. Prevention relies on universal precautions, as no vaccine is available. Management of needle stick injuries involves HCV RNA testing of the source and anti-HCV testing of the exposed individual.
  • Universal precautions are essential to prevent contact with blood and bodily fluids. These include barrier protection, hand hygiene, and safe handling of sharp instruments. Prompt notification and action are necessary following an exposure incident. Awareness and timely treatment are crucial for managing HBV and HCV infections.

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