How to protect ourselves from viral hepatitis

07.09.2021
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How to protect ourselves from viral hepatitis

You are very important for us, therefore MediHelp International provides you the access to critical information for your wellbeing offered by prof. Irinel Popescu, a leader in surgical oncology and liver-related medical procedures.

The most common cause of viral hepatitis is represented by B and C viruses. 325 million people are currently infected with these viruses worldwide. About 1.5 million of them die each year. One person dies every 30 seconds from complications of viral hepatitis.

Both viruses are extremely dangerous since:

  • They always lead to chronic hepatitis and this often turns into cirrhosis of the liver. No curative treatment is currently in place for cirrhosis; it is a disabling disease that requires repeated hospitalizations. The patient with cirrhosis can no longer live on a normal life and, finally, needs liver transplant (in the absence of which the patient dies by complications of cirrhosis)
  • Both B and C viruses are oncogenic viruses, so they lead to the appearance of liver cancer (hepatocarcinoma). The oncogenic capacity is manifested even if the patient does not have cirrhosis, but it is much higher when it has reached the stage of cirrhosis.

Currently, the medicine has therapeutic means against both viruses.

Modern treatments for C virus have proved to be very effective, and their discovery was even crowned with the award of the Nobel Prize. The rate of healing achieved is impressive, but the adverse effects of the treatment, although minor, can occur.  However, the current treatment against C virus can be generally considered curative.

Progress has also been made in the treatment of B virus, but not so spectacular. There is no curative treatment for the B virus at the moment.

Instead, there is a highly effective vaccine against the B virus.

As we all know, a disease is easier to prevent than to treat. Therefore, viral hepatitis screening programs have been introduced all over the world. Such a program currently exists in Romania, given that our country and Latvia are the countries with the highest prevalence of C virus in the general population.

The effectiveness of screening programs has been assessed in Germany. It is estimated that, through these programs, the total number of patients with C hepatitis will decrease from 275,000 in 2015 to 14,000 in 2040. Taking into account both the high cost of treatment and the potential adverse effects, it is considered that such programs are very necessary and justified.

HCV infection screening is currently based on the detection of anti-HCV Ac (antibodies against C virus) and of B virus infection on the detection of Ag HBs (surface antigen of B virus).

There are rapid diagnostic tests (RDT) that use serum, plasma or blood fully from the finger, but there are also tests by which determinations are made from saliva.

WHO recommendations are that the screening be performed on the entire population (”universal screening”). It is recommended to use a single test (RDT or ELISA) for the detection of Ag HBs (which highlights the B virus infection) and of Ac anti HVC (which highlights the C virus infection).

The screening programs, which have already started in Romania (such a program is coordinated by the Fundeni Clinical Institute), aim to carry out an activity of informing and educating the population by all means and, first of all, by the media. Non-governmental organizations of patients are also involved in this undertaking.

An important role in the screening programs belongs to the family doctor, who knows the patients and can fit them into the risk categories. As it is known, the risks are higher in those who use injecting treatments and those who receive blood transfusions; also, illegal injecting drug users are a particularly exposed category. The homeless and those living in extreme poverty are equally exposed.

The family doctor is the one who determines the type of tests, who performs and interprets them; the family doctor will also be the one who sends the patient to the specialist doctor when it has been positively detected. Also, in collaboration with the specialist doctor, ensures the monitoring of the patient throughout the treatment.

If the initial testing is negative, it should be repeated at an interval of 2-3 years.

Regarding the B virus, there are programs of prophylaxis of transmission of infection from mother to child, and vaccination is recommended immediately after birth; in Romania there is such a program, which starts in maternity and continues through the paediatric network.

For adult patients, it is also recommended the vaccination against the B virus. This is especially true for some vulnerable categories: doctors and nurses, chronically dialyzed patients, patients who receive long-term injectable treatment and blood transfusions, immunocompromised patients, etc.

With all the hardships urged by the pandemic, both the screening programs and the early treatment of the infections detected with B or C virus must continue, through a joint effort of those involved, doctor and patient.

Prof. Irinel Popescu is a prominent surgeon and a member of the Romanian Academy of Sciences. He is a leader in surgical oncology and liver-related medical procedures. For the last three decades, Prof Popescu has been the pioneer and motivator of liver transplants in Romania and the founder of a Romanian school for liver transplantation.
Prof. Popescu is a social contributor in raising the public awareness for organ donation, which Romania is still showing a very sluggish progress in.
He is a member of many local and international medical associations and a respectable writer and speaker in the most important medical and surgical conferences.
Prof. Popescu serves as the President of the Romanian Academy of Medical Sciences and as a Corresponding Member of the Romanian Academy.


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