World Hepatitis Day 2023: Understanding The Connection Between Hepatitis And Liver Cancer

Hepatitis, usually referred to as the swelling or inflammation of the liver, has multiple causes, including alcohol, medications, drugs, and toxins.

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New Delhi: World Hepatitis Day is celebrated every year on July 28, which signifies the importance of caring for liver health. The liver is one of the most essential human organs. However, it is devastating to hear that there were over one million+ deaths due to the impact of hepatitis, and still, 354 million people globally have Hepatitis.

What Is Hepatitis?

Hepatitis, usually referred to as the swelling or inflammation of the liver, has multiple causes, including the attack on the liver by the body's immune cells and infections from different types of viruses. Another cause of Hepatitis is liver damage due to alcohol, medications, drugs, and toxins. The five main viral classifications of hepatitis are hepatitis A, B, C, D, and E. A different virus is responsible for each type of viral hepatitis. 

Apart from the cause and the timely treatment, the type of Hepatitis also decides the level of damage to the liver. Hepatitis A is generally short-term, but Hepatitis B and C impact most people and often lead to chronic liver conditions. 

Symptoms Of Hepatitis:

The common hepatitis symptoms in case of prolonged conditions include fatigue, bloating, pain, inflammation, weight loss, dark urine, clay-coloured stools, jaundice, loss of weight, weakness, and other conditions that depend on the liver condition, personalized health, age, and immunity of an individual. 

The condition gets alarming when there are no symptoms in the initial stage of Hepatitis B and C, but later leads to liver failure and, in more chronic conditions, proves to be fatal. 

Hepatitis To Liver Cancer And Other Liver Issues:

Now, the damage due to Hepatitis on the Liver completely depends on how you deal with it. If hepatitis is diagnosed at an early stage, it quickly gets better. However, if Hepatitis remains undiagnosed and untreated, it can lead to more severe conditions like Liver Cirrhosis, Liver Cancer, Liver Failure, and Liver Damage.

Dr. Devavrat Arya- Director of Medical Oncologist, at MAX Hospital, Saket, New Delhi said, "Hepatitis, particularly chronic hepatitis is a difficult illness that needs specialized treatment. The risk with chronic infection is not only chronic liver disease and cirrhosis, but also the fact that these patients will be at a much higher risk of getting liver cancers (hepatocellular carcinoma ). In fact, chronic viral hepatitis remains a major cause of liver cancers worldwide."

"Additional factors that may influence the risk of liver cancer in chronic hepatitis patients include older age, male sex, Hispanic ethnicity, diabetes and obesity, smoking, HCV genotype 3, alcohol abuse, and co-infection with HIV or HBV," he further went on to say.

Adding to that, he said, "In patients with a chronic viral infection, antiviral therapy and suppression/cure of viral replication are associated with a significant reduction in the risk of HCC development and recurrence. Surveillance with a 6-monthly ultrasound is only recommended for selected patients with chronic hepatitis."

Talking about the HBV virus, Dr Maya V, a Gynaecologist, at Ayu Health, told that the Hepatitis B virus (HBV) is an oncogenic virus that causes liver cancer at the same rate as someone who actively smokes one pack of cigarettes per day. 

For maintaining liver health and keeping yourself and your family safe from Hepatitis, it is important to go for regular checkups. Some essential tests include Autoimmune Blood Markers, Blood Tests for Hepatitis A, B, and C, and Liver Function Tests. Also, in case of fluid is filled in the abdomen, some physical examinations might be required to check the yellowing of the skin, enlarged liver, and liver scan. 

In this regard, Dr Sohini Sengupta at Redcliffe Labs suggests that one should not wait for the Hepatitis symptoms to appear. For a healthy liver and a healthier life, one should seek a hepatitis health check as a preventive measure periodically. It will keep you healthy and help you make informed decisions.

How Can Hepatitis Affect People Suffering From HIV, TB, Or Malaria?

"TB and HBV co-infection increases the risk of hepatotoxic effects of anti-tuberculous drugs," says Dr. Neha Chaudhary, Associate Consultant, Gastroenterology, Hepatology & Endoscopy, Max Hospital, Gurgaon. "This is because hepatitis infection results in liver damage, making the organ more susceptible to drug-induced damage. In patients with liver disease, tuberculosis treatment can increase the likelihood of liver failure. Timely treatment with antiviral drugs can lower the risk of drug-induced liver injury caused by the hepatotoxic effects of anti-tuberculous drugs."

Talking about patients with HIV infection, she said that they are at a higher risk of developing cirrhosis, hepatic decompensation, and hepatocellular carcinoma than patients diagnosed with only chronic HBV infection.

"Treatment of HIV infection may improve the virologic, histologic, and clinical evolution of chronic HBV infection. Several antiretroviral agents have activity against HIV and HBV, whereas others, such as entecavir, have limited activity against HIV but lead to the development of HIV-resistant strains if used alone. Prior to the initiation of ART, all patients who test positive for HBsAg should be tested for HBV DNA using a quantitative assay to determine the level of HBV replication. Patients with chronic HBV infection already receiving ART active against HBV should undergo quantitative HBV DNA testing every 6-12 months," she further added.

HBV patients also have a higher risk of contracting malaria and HBV could negatively affect the prognosis of malaria infection. HBV and malaria co-infection significantly affect the haematological and liver function indices of malaria patients. 

Mother-To Child Transmission Of Hepatitis B:

Talking about mother-to-child transmission, Dr. Neha said, "Routine screening of pregnant women for HBsAg and universal childhood hepatitis B vaccination should be done to prevent mother-to-child transmission of hepatitis B. HBIG should be administered to babies born to HBsAg-positive mothers and provision of maternal antiviral prophylaxis to infected mothers with high viral load have been in place to prevent mother to child transmission of HBV."

WHO recommends that all infants should receive their first dose of the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours, followed by two or three doses at least four weeks apart to complete the vaccination.