Nine out of 10 people with hepatitis B are unaware they have the disease
Doctors in the UAE are urging residents to be screened for viral hepatitis, a leading cause of liver damage and cancer, as the world marks Hepatitis Day today.
Dr Shiva Kumar, chair of gastroenterology and hepatology at the Cleveland Clinic Abu Dhabi (CCAD), warned that hepatitis can go unnoticed.
“Hepatitis often goes undiagnosed as people don’t tend to notice any symptoms until it has already damaged the liver. It is important that people are screened, because a simple test can help them avoid serious complications and permanent damage.”
He explained that hepatitis is an inflammation of the liver, often caused by a viral infection. The condition can either be acute, lasting less than six months, or in some cases become chronic, necessitating careful management and treatment.
While vaccines for hepatitis A and B are available, there is currently no vaccine that can protect against hepatitis C, a leading cause of cirrhosis and liver cancer in the UAE. Nine out of 10 people with hepatitis B are unaware they have the disease.
Health experts said raising awareness is the key when it comes to reducing the number of cases witnessed by doctors throughout the country.
She pointed out that hepatitis screening consists of a simple blood test to identify the presence of the virus. If a patient tests positive for the virus and is found to have advanced liver damage or fibrosis, physicians can assess prognosis their liver function using an advanced nuclear medicine technique. The technique is currently only available at the CCAD and a few facilities in the US.
The detailed liver function assessment allows doctors to determine the type and extent of treatment required. Patients who test negative for viral hepatitis may be offered hepatitis A and B vaccination to prevent them acquiring the condition in the future.
If left untreated, chronic viral hepatitis can lead to a range of serious complications such as cirrhosis, liver failure and even cancer.
Once a patient develops such complications, they may require complex surgery, including liver resection and even liver transplantation.
“Patients suffering from chronic viral hepatitis are at risk of developing cirrhosis, which can then progress to liver failure or liver cancer. Once a patient’s liver is damaged to the point they develop liver failure, a liver transplant is the only option we have to save their life.”
Chronic cases often unnoticed
Dr Sally Abdulla Mahmoud, lab director and acting medical director at Medeor 24×7 International Hospital, Al Ain, said the hospital receives around 20 patients each year diagnosed with either hepatitis A, B or C. She said majority of the patients diagnosed with hepatitis A are Indian and Egyptian nationals.
Dr Mahmoud added that with hepatitis B, doctors and patients often discover the illness “by chance”. “Only by chance when we are doing the pre-operative investigations, we find they are positive.”
She added the hospital has also received cases of children diagnosed with hepatitis A, in which they would require immediate treatment. “In every six months, we receive at least one positive case which is usually severe – causing diarrhea and vomiting.”
The hospital also received two alcoholic hepatitis cases this year, which lead to liver failure. “Usually the patients just come with abdominal pain and nausea and only by chance we find the hepatitis marker is high.”
Dr Riyaz Mather, specialist internal medicine at the Universal Hospital, said although 95 per cent of people with hepatitis A can be cured, around five per cent can develop fulminate hepatitis, which can lead to liver failure or liver cancer.
Moreover, while hepatitis A spreads through fecal-oral route, hepatitis B often spreads through blood or blood products, he said. “This includes the use of needles and medical products. This puts people in the health sector, including doctors and nurses at high risk of developing it.
“Around 50 per cent of hepatitis B cases, the person might get an infection then get cleared over a period of around three months.”
However the other 50 per cent of cases, the infection can remain in a dominant carrier status throughout the patient’s life. “In such a case, that person can infect any other person throughout his life, and the infection can be through fluid exchange. The chronic infection can lead to liver failure and even cancer.”
The recall comes after the detection of impurities in it
The Ministry of Health and Prevention (Mohap) has ordered the recall of some antihypertensive medicines containing the active substance valsartan that is supplied by Zhejiang Huahai Pharmaceuticals, a company in Linhai, China. The recall comes after the detection of impurities in it.
This recall is a precautionary measure taken by the ministry following a report issued by the European Medicines Agency indicating the detection of a contamination of the active ingredient with N-nitrosodimethylamine (NDMA), a chemical that might lead to cancer.
Valsartan is a medicine used for the treatment of hypertension to prevent related cardiovascular complications.
The Mohap explained that other medicines containing Valsartan manufactured using the same active ingredient from other sources are safe to use.
Swiss multinational pharmaceutical compaany Novartis informed the ministry that their products containing Valsartan – Diovan, Co-Diovan Entresto and Exforge – are not impacted because these products do not contain the active ingredient from an external supplier.