hierarchy,” he said. He added pre-operative screening of patients for Hepatitis-C is not performed routinely. Rate of hepatitis C due to dialysis is much higher in Pakistan. The causes could be the negligence in disinfecting dialysis equipment or reusing vials between different patients, he said while responding to a query.
He added the improper disposal of hospital waste is one the most common contributing factors associated with spread of Hepatitis-C. Besides this, drug abusers and sex workers are also common factors in acquiring hepatitis C in Pakistan, he said.
According to Professor Ashraf, high risk groups are injecting drug users, health care workers (due to needle stick injury), newborn to Hepatitis-C infected mothers, household contacts of infected persons, persons who frequently use blood or blood products and persons with multiple sexual partners and with high-risk sexual behaviour, elderly people and those living with HIV.
To a query, he said the main signs and symptoms of viral hepatitis are fatigue, nausea, vomiting, loss of appetite, jaundice (yellowing of the skin and eyes), abdominal pain and dark urine and bright stools, depression and joint pains in case of Hepatitis-C.
“The most frequent symptom of hepatitis is that people feel very tired, however, blood test is required for confirmation of diagnosis of viral hepatitis,” he said. He added that ELISA is screening test and PCR is confirmatory test for Hepatitis-C.
He is of the view that Hepatitis-B and C are both ‘silent viruses’ and because many people (about 80%) feel no symptoms, you could be infected for years without symptoms. If left untreated, both the Hepatitis-B and C viruses can lead to liver scarring (cirrhosis), ascites (accumulation of fluid in the abdominal cavity), bleeding, coma, liver cancer, liver failure and death. Therefore, it is important to get tested as soon as possible, he suggested.
He explained that about 90 per cent of healthy adults who are infected with HBV will recover and be completely rid of the virus within six months, but 10 per cent become chronic carriers of the disease; whereas in case of Hepatitis-C, four out of five people (55 to 85%) develop a chronic infection, which may cause cirrhosis and liver cancer after 15-30 years.
He said there is currently no vaccine for Hepatitis-C, however, 50 to 90 per cent cases of Hepatitis-C can be treated, but access to diagnosis and treatment is low. Combination antiviral therapy with interferon and ribavirin has been the main stay of hepatitis C treatment, he said.
Recently, new, very effective oral anti-viral drug, ‘Sovaldi’ has been introduced, but it is very expensive. Cost of 28 tablets is around Rs55,000 and a patient had to bear total expense of nearly Rs 200,000 for Sovaldi drug for a complete course, said Professor Ashraf.
He added even if treatment is not an option for you, you can do something about your disease. A healthy lifestyle is important.
He said awareness about various aspects of hepatitis is inexplicably low and the majority of those infected are unaware. Creation of awareness among people through mass media about measures to prevent hepatitis is a need of the hour to check the growing incidence of fatal disease.