A liver disease that spreads through multiple means is killing more people in India than AIDS

One million people in India are at risk every year of contracting hepatitis, an infection that spreads in more than one way. On World Hepatitis Day, we present all the myths and facts one needs to know to prevent it.

AIDS (acquired immunodeficiency syndrome), which is caused by HIV (Human Immunodeficiency Virus) was considered an epidemic after the 1980s; India recorded its first official case in 1986, after which measures were taken to curb the spread of this deadly disease. Today, roughly over two million people in India are HIV-positive. But how many of us are aware that there are over 40 million Indians affected by another disease, which spreads in ways similar to and different from HIV, making it more dangerous?

The hepatitis virus, unlike HIV, takes many forms, each targeting the body in different ways, which makes awareness of this disease understandably low. World Hepatitis Day is recognised every year on this day to address this level of low awareness. Nearly 6,00,000 people succumb to it each year. Considering how common it is, how vulnerable can one be to the disease? How does it spread? Is it life threatening? Here’s all you need to know:

Jaundice and hepatitis: what’s the difference?

Hepatitis is a viral infection that causes an inflammation (swelling) of the liver tissue. Jaundice, on the other hand, is caused due to high levels of bilirubin pigment in the liver, which in turn results in a yellow colouration of the skin. While these two conditions are not the same, jaundice can be caused by a hepatitis infection.

Due to this, there is often a common misconception that jaundice is the marker for hepatitis, and that one cannot have hepatitis if one doesn’t have jaundice. In fact, acute hepatitis manifests itself with other symptoms, like poor appetite, vomiting, diarrhoea, and fatigue; jaundice may or may not accompany these symptoms.

Hepatitis can only spread through sexual contact: myth

This misconception is drawn from the similarity between HBV and HIV infections. In reality there are five types of hepatitis infections caused by five groups of viruses: Hepatitis A, B, C, D and E. HBV and HCV spread through blood and bodily fluids, similar to HIV. HAV and HEV, on the other hand, spread through the faecal-oral route; that is, through faecal-contaminated water and food. HDV is rare and occurs only in 10-20 percent of HBV-positive patients (10-20 percent).

HBV can also be transmitted perinatally from mother to child. Both HBV and HCV are transmitted through unsafe sex, blood transfusions, and contaminated medical equipment. None of these five types can spread through casual contact—so long as sanitation is maintained—like hugging, sharing food and water, sneezing or coughing, or even mosquito bites.

Like any infection, it is easily detected: myth

Most people with chronic hepatitis (lasting for more than six months) live without symptoms for many years till the development of liver cirrhosis or cancer – wherein it becomes too late for treatment. This is reportedly the case with about 95 percent of those infected. Let's put the severity of this disease in perspective: over 40 million people are chronically infected with Hepatitis B and close to 12 million are chronically infected with Hepatitis C, making this the leading cause of death over HIV.

Vaccination and cure easily available: myth

The government of India has included Hepatitis A and B under its vaccination programme. Vaccination for Hepatitis C, however, is not currently available. Research, however, is under way. The treatment for Hepatitis C is out of reach for the larger population due to its heavy costs. The medicine is presently available in India for Rs 20,000. Even the cost of diagnosis is high and stands at Rs 15,000. Considering that India has the highest number of people living under the poverty line, the high costs of diagnosis and treatment and unhygienic living conditions of the poor adds to prevalence of hepatitis in the country.

Related read: Diseases are our biggest killers; how prepared are we to fight them?

It is also a misconception that hepatitis is caused only by the virus. Since it is essentially inflammation of the liver, it can also be caused by excessive alcohol use, toxins, certain drugs, autoimmune diseases and other infections. It is, however, only the virus that is transmissible.

According to National Centre for Disease Control, one million people are at risk each year. India has the second highest prevalence of HBV and amounts to 15 percent of the global pool of the infection. The numbers reflect a grave situation, the mitigation of which can only be better awareness, better policies to prevent, manage and cure, and better research and development.