- Date : 05/01/2018
- Read: 8 mins
Every year, hepatitis affects and kills millions of people worldwide. This makes it essential to diagnose and treat it on time.
Mira Tejani was elated when her pregnancy result came back positive. She was finally going to be a mother! But, three months into her pregnancy, she started experiencing loss of appetite and severe fatigue, which she brushed aside as part of pregnancy. Unfortunately, it worsened into body ache and frequent vomiting. So, she consulted her doctor, who then suggested a blood test for hepatitis B.
Mira was devastated. If her results were positive, there was a high chance that her baby would contract the hepatitis B virus (HBV) at birth. More than anything, she worried about the stigma attached to this disease. Would her family still support her?
What is hepatitis?
Hepatitis is an inflammatory condition of the liver, and is generally caused by a viral infection. However, it is also possible to contract it from the abuse of certain drugs, medicines, toxins, and alcohol. Autoimmune hepatitis is another possibility that occurs when your body produces antibodies against your liver tissue. Sometimes, hepatitis can progress to fibrosis, cirrhosis, or liver cancer. Fibrosis is the scarring of tissues. In the case of cirrhosis, the scar tissue replaces the healthy tissues in your liver.
Types of hepatitis
There are five major types of hepatitis viruses: A, B, C, D, and E. Each virus comes from a different source and produces different symptoms in the body. Hepatitis B, C, and D are chronic, while A and E are acute and short-term.
Caused by the hepatitis A virus (HAV), it can be contracted by ingesting food or water contaminated by the faeces of an infected person.
- Loss of appetite
Treatment: While there is no specific treatment for hepatitis A, certain medicines must be avoided. Hospitalisation becomes necessary, only if the patient has acute liver failure.
Prevention: HAV is rarely fatal, but can be prevented by drinking clean water, practising good personal hygiene, and ensuring proper sewage disposal. There are also several vaccines that introduce antibodies to make the body immune to HAV.
The HBV is transmitted by infected body fluids such as blood or semen. Intravenous drug use, sharing razors or toothbrushes, and sexual intercourse with an infected person increase the chances of getting HBV. This is a chronic infection, and eventually leads to a life-threatening liver disease or liver cancer.
- Abdominal pain
- Nausea and vomiting
- Loss of appetite
- Joint pain and severe fatigue.
Treatment: Acute hepatitis B has no treatment. Adequate fluids and a nutritious diet are recommended. Chronic hepatitis B is treated with medicines that reduce the chances of liver cancer, slow down cirrhosis, and improve survival rate. However, medicines cannot cure this infection entirely; they merely suppress the virus. So, people who start this treatment must continue it throughout their lifetime.
Prevention: Infants must get the hepatitis B vaccine within hours of birth. A World Health Organisation (WHO) study in 2015 showed that prevalence of the HBV infection among children dropped to 1.3% from 4.7% in the pre-vaccination era.
It is caused by the hepatitis C virus (HCV), which is transmitted through infected body fluids. Intravenous drug use and sexual contact with an infected person can cause this.
- Low appetite
- Vomiting and nausea
- Abdominal discomfort
- Joint pain
Treatment: Usually, the body’s immune response clears the infection. Even those with chronic infection rarely develop liver damage. The strain of the virus and type of treatment determine whether the HVC is curable or not. With new medicines, cure rates are at 95%. But these are expensive and usually unaffordable in middle and low-income countries. Generic medicines have been introduced to make them more affordable, but access remains limited in most countries.
Prevention: There is currently no vaccine for hepatitis C. Prevention is possible with healthy personal hygiene, safe use of injections, proper disposal of health-care waste, avoiding drugs, and safe sexual practices.
Caused by the hepatitis D virus (HDV), this ‘super-infection’ only occurs along with hepatitis B. It is also called ‘delta hepatitis’ and is a fatal liver disease. This is the most severe form of hepatitis as it causes faster progression of the symptoms.
- It accelerates the symptoms of HBV infection
- Causes cirrhosis and fibrosis in a short time
Treatment: Limited treatment is available for acute or chronic HDV infection. Pegylated interferon-alpha is the only drug that is effective against HDV. Treatment could last for up to a year. Unfortunately, most patients relapse after discontinuing treatment. Liver transplantation is a possible treatment, but is unaffordable in most countries.
Prevention: Preventing HBV will prevent an HDV infection as well. All those unaffected by HBV must get the HBV vaccination. Never reuse needles and syringes, ensure that blood is checked before a transfusion and avoid drugs to reduce the chances of getting this deadly disease.
How many people are affected by Hepatitis
Each year, around 1 million Indians are at risk of contracting Hepatitis B
A 2014 report by National Centre for Disease Control said that about 1 lakh of them die from the infection
The report also said that around 1% of India’s population is expected to be infected with HCV
More than 15 million people across the world suffer from HBV and HDV
This water-borne disease is caused by the hepatitis E virus (HEV), which is found in contaminated water and in areas with poor sanitation. It lasts between one and six weeks and is rarely fatal. In rare cases, acute hepatitis E may result in acute liver failure, which can be fatal.
- Abdominal pain
- Itching and rashes
- Joint pain
- Enlarged liver.
Treatment: Patients generally do not need hospitalisation, unless liver failure occurs. Antiviral drugs may be prescribed. A drug called ‘interferon’ can ease symptoms.
Prevention: Drinking water must be free of contaminants. A proper sewage system and maintaining personal hygiene is a must. Avoid taking ice unless it is made of pure drinking water.
Cost of Hepatitis treatment
When Mira’s blood test returned positive for HBV infection, several forms of treatment were suggested to reduce the risk of transmitting the virus to the baby. She was advised to avoid certain medicines, quit alcohol permanently (as it is toxic and damages liver cells), and start antiviral therapy. She would also need lifelong HBV vaccination and follow-up care, and her baby would need vaccination within hours of birth to avoid contracting the virus.
Keeping the diseases under control became a bit easy, unfortunately, Mira’s finances took a hit. The cost of diagnosis, medicines, treatment, and lifelong care was so high that the entire treatment cost her lakhs of Rupees.
There are around 12 million reported cases of hepatitis C in India. Even generic medicines cost Rs. 67,000 for the entire course of treatment.
The medicine for hepatitis B - ‘Entecavir’ - is currently the most expensive medicine in the world. But the patent on it expired in February 2015. Hence, India can now mass-produce this drug at Rs. 2,200 for an entire year’s course. That said, the bill could still run up, given the long treatment period. There could also be surgeries and hospitalisation costs in case of complications, which could become quite expensive.
Can insurance help against hepatitis?
- Health insurance covers can help patients deal with the financial burden that comes with this disease.
- Medicines for treating hepatitis are generally expensive, so there are certain conditions patients may have to meet for health insurance to cover them.
- If you buy a health insurance plan, along with a critical illness rider (that covers hepatitis), and are later diagnosed with this disease, you could be eligible for the predetermined pay-out stated in your plan.
- In some cases, only cost of medication is covered by insurance.
- On the other hand, buying health insurance after being diagnosed with hepatitis could result in two outcomes- you will either have to pay higher premiums or could be denied coverage from the insurer.
Insurance premiums and coverage differ from case to case. So, get all the necessary information about the cover, and check with an insurance agent before buying a plan.
Insurers usually offer cover after analysing a patient’s condition. Some commonly asked questions include, how long have they been living with hepatitis? What symptoms have they witnessed in the last six months? Current medication, recent diagnostic tests and medical reports etc.
The cost of premiums depends on the type of hepatitis, treatment history, recovery condition, and the medical history.
Had Mira bought insurance at the right time, she could have saved some of her hard-earned money. The cost of the treatment is several times higher than the cost of an insurance premium. Hence, it is always a good to buy an insurance cover to protect yourself against life’s uncertainties.