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Pakistan is an endemic country for both hepatitis B and C. Roughly
seven million Pakistanis, or 5 % of the population, are carriers
of hepatitis B and the figure for hepatitis C is even larger. These
findings were disclosed by Dr S. M. Wasim Jafri, Professor and Chief
of Gastroenterology and Chairman, Department of Medicine at Aga
Khan University, during a 'Signs, Symptoms, and Care' health awareness
programme held at Aga Khan University Hospital (AKUH) Clifton Medical
Services on Thursday, September 23, 2004. "This alarming spread
is putting enormous pressure on an already resource-strapped health
care system," he said.
Dr
Jafri attributed the rising incidence of hepatitis B and C to poor
awareness, lack of basic health care and below-par screening facilities.
In particular, he pointed to the multiple use of disposable needles
and syringes, substandard transfusion services, quackery and poor
dental health care.
He
stressed the critical importance of vaccination against hepatitis
B and said that vaccinating all newborns on the day of birth would
result in a substantial drop in incidence over the next decade. "This would also control mother-to-infant transmission of hepatitis
B, which occurs at the time of birth or just thereafter," said Dr
Jafri. "Ninety-five per cent of infants who acquire infection very
early in life become chronic carriers of hepatitis B and may suffer
from chronic liver disease and hepatocellular carcinoma in adolescence.
However, less than 10 % of patients become carriers if the infection
is acquired in adult life." In adults, the vaccine should be offered
to people at high risk, such as health care workers, phlebotomists,
dentists, paramedics and nurses," he added.
Elaborating
on the current management of hepatitis C, Dr Jafri maintained that
if the disease is detected in time, chances of effecting a cure
with the currently available treatment, which is based on Interferon
and Ribavarin, stand at almost 80 to 90%. This treatment is, however,
expensive. "But the disease cannot be cured if it progresses to
the cirrhotic stage, and emphasis should therefore be placed on
timely diagnosis of the disease."
Commenting
on the treatment of hepatitis B and C in Pakistan, he said that
treatment available in the country is at par with the rest of the
world. He concluded by urging the government and NGOs to work together
to control the spread of hepatitis B and C in Pakistan.
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