25% of the people infected with chronic hepatitis B infection are at risk of developing cirrhosis of the liver
More than 360 million people around the world suffer from chronic Hepatitis B infection, a severe viral infection that mainly affects the liver. An alarming 40 million of these are in India alone. This number is only an estimate, as many don’t even know that they are infected. The World Health Organization (WHO) states that lack of access to treatment and diagnostic facilities, and basic public awareness is a major challenge.
Approximately 25% of the people infected with chronic hepatitis B infection are at risk of developing cirrhosis of the liver, or hepatocellular carcinoma (liver cancer) eventually leading to death. While the hepatitis B virus (HBV) does not spread through direct contact or via air or water, it is known to be a blood-borne virus transmitted via blood or contaminated body fluids (saliva, semen, etc.) and from mother to newborn.
Speaking about this, Dr M Udaya Kumar Maiya, Medical Director, Portea Medical said, “Every year, a staggering 1 million newborns stand the risk of developing chronic HBV infection. HBV can spread from infected mothers to their infants at birth (natural or through C-section) due to active contact with blood. However, there is little or no evidence of in-utero transmission or infection through breastfeeding. About 90% of newborns exposed to HBV go on to develop the chronic form of the disease. Every individual who is a chronic carrier of HBV will continue to be infected throughout his/her lifetime and can go on to infect others. Similarly, infants who are exposed at birth will retain the virus in their system throughout life. It is therefore critical that infants are immunized at birth. “
If the mother is a carrier of HBV and has tested positive for e-antigen as well (which is the case 40% of the times ) then her newborn must essentially receive the vaccine within 12 hours of birth.
While there is no effective cure for hepatitis B infection, research shows that the vaccine offers more than 90% protection to individuals. To lower the burden of hepatitis B infection among other chronic and communicable diseases, the Government of India has included the hepatitis B vaccine (Hep B) as part of the Universal Immunization Programme (UIP). According to WHO , routine immunization of children as part of national campaigns can not only achieve high coverage but also result in long-term remission or complete elimination of the disease within a period of 10 to 15 years.
Adding further, Dr Maiya said, “As per the UIP, Hep B schedule begins at birth with the first dose being administered within the first 24 hours of life. Three more doses of the vaccine are given at 6, 10 and 14 weeks of age along with other scheduled vaccines. No booster doses are recommended, as the initial phasing itself is 95% effective and sufficient to offer lifetime immunity. It is also imperative that expectant mothers get tested for presence of the virus before the due date, as many women are not aware that they are carriers of HBV. However, vaccinating the mother who is known to be a chronic HBV carrier during pregnancy is not indicated. “
It is to be noted that prevention of mother-to-infant transmission of HBV is at the center of strategic control of hepatitis B epidemic in the country because despite the existence of other precautionary measures, the former is the most vulnerable route of transmission. In the absence of prevention of mother-to-child infection, approximately 3% to 5% of newborns will continue to develop hepatitis B in any given region . Hep B vaccine is known to be effective if given within 24 hours, even in case of exposure to the virus. Unlike BCG and other vaccines, which are given to prevent future infections, the first dose of Hep B is a post-exposure prophylaxis. The efficacy of the vaccine decreases with increase in time between birth and administration of first dose. All this makes administering the vaccine at birth critical, especially in babies born to infected mothers. –
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