Current Scenario of Hepatitis B and Its Treatment in India
Open Access
- 8 July 2017
- journal article
- review article
- Published by Xia & He Publishing in Journal of Clinical and Translational Hepatology
- Vol. XX (XX), 1-20
- https://doi.org/10.14218/jcth.2017.00024
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.Keywords
This publication has 138 references indexed in Scilit:
- Serum ferritin and the risk of hepatocellular carcinoma in chronic liver disease of viral etiology: A case–control studyIndian Journal of Gastroenterology, 2013
- Characterization of Treatment-Naive HIV/HBV Co-Infected Patients Attending ART Clinic of a Tertiary Healthcare Centre in Eastern IndiaPLOS ONE, 2013
- Relevance of hepatitis B surface antigen levels in patients with chronic hepatitis B during 5 year of tenofovir treatmentJournal of Viral Hepatitis, 2013
- Living related liver transplantation for hepatitis B-related liver disease without hepatitis B immune globulin prophylaxisLiver Transplantation, 2013
- Characterization of antiviral resistance mutations among the Eastern Indian Hepatitis B virus infected populationVirology Journal, 2013
- Laboratory Evaluation of Three Regimens of Treatment of Chronic Hepatitis B: Tenofovir, Entecavir and Combination of Lamivudine and AdefovirJournal of Laboratory Physicians, 2012
- Distribution of Hepatitis B Virus Genotypes and Its Association with Severity of Liver Disease in Patients with Chronic Hepatitis B in Uttar Pradesh, IndiaIndian Journal of Virology, 2011
- Distribution of Hepatitis B virus genotypes among healthy blood donors in eastern part of North IndiaAsian Journal of Transfusion Science, 2011
- Clinical Significance of Genotypes and Precore/Basal Core Promoter Mutations in HBV Related Chronic Liver Disease Patients in North IndiaDigestive Diseases and Sciences, 2009
- Drug Trafficking Routes and Hepatitis B in Injection Drug Users, Manipur, IndiaEmerging Infectious Diseases, 2006