Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Tuesday, 10 / 24 / 2017

Articles

Current Scenario of Hepatitis B and Its Treatment in India

REVIEW ARTICLE

Current Scenario of Hepatitis B and Its Treatment in India

Gautam Ray*

Gastroenterology Unit, Department of Medicine, B.R.Singh Hospital, Kolkata, India

*Correspondence to: Gautam Ray, B.R.Singh Hospital, Sealdah, Kolkata 700014, West Bengal, India. Tel: +91-3323504075, Fax: +91-323507003, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2017;5(3):277-296 DOI: 10.14218/JCTH.2017.00024
Received: March 18, 2017 Accepted: June 3, 2017 Published online: July 8, 2017

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

Hepatitis B, Epidemiology, Clinical, Prevention, Treatment, India

 

 

Journal of Clinical and Translational Hepatology 2017 vol. 5, 277-296 Html ] [ PDF Full-text ]

 

© The Authors 2017. This article is published under the terms of the Creative Commons Attribution-Noncommercial (CC BY-NC) License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

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