Dr Vivek Raj, director of department of Gastroenterology and Hepatology at Max Healthcare, joined IBNLive readers for an interaction on hepatitis in India and the available preventive technologies.
Q. I am hepatitis B positive and non reactive. My fibroscan suggest 6.5 Kpa stiffness. Liver Biopsy shows possibility of nonalcoholic steatohepatitis/no significant fibrosis. I have lost my maternal uncle and aunt due to liver cirrhosis. I am taking LIV 52(HB) + cap evion 400 mg. Is there any thing serious which needs to be taken care of. Asked by: Sushil Gupta
A. You should get LFT, Alpha Fetoprotein and U/S annually since the risk of Hepatic cancer is higher in HBSAg positive patients even if they do not have active liver disease. If HBV DNA has not been done then that should be done at least once. For Non alcoholic fatty liver, exercise (aerobic 1/2 hr a day) and diet control (Low fat, low carb diet) is essential and has better results than any other medication.
Q. What are preventive health test for hepatitis, HIV and STDs for 30+ man? Asked by: Pawan
A. For HIV, HIV serology, for hepatitis B- HBSAg,are screening tests. They do not prevent the diseases, just test for prsence of these. There are many STDs and therefore no single test can test for all. For syphilis VDRL, for Gonorrhea, urethral swab abd culture etc. You need to see a specialist for accurate testing for STD.
Q. How does someone gets infected by hepatitis? What is the rate of replication of virus and what are the survival statics researched so far? Asked by: Harvey Dent
A. Hepatitis A and E are transmitted by infected water and food. Usually rapid onset of symptoms and clinical course is self limiting with most patients recovering in 6-8 weeks. Mortality is 0.1-1 percent, but much higher in pregnant women (upto 20-25 percent with Hep E) Hepatitis B and C are transmitted via infected blood or blood products or sexual transmission. Hepatitis B infection in adults causes acute hepatitis with jaundice in 70-80 percent cases and is subclinical in rest. About 5 percent risk of becoming chronic and progressing to cirrhoisis, about 90 percent patients clear the virus and 5 percent become asymptomatic carriers Hepatitis C causes mild hepatitis. 15-20 percent clear the virus but 80 percent develop chronic low grade hepatitis which can progress to cirrhosis in 20 percent cases over 15-20 years
Q. Sir, I am a patient of Gastro, I feel like my stomach is a balloon if its empty tried many medicines like Pantocid L tried but no permanent fix. What diet and routine should I follow to cure this? Asked by: Sandeep
A. You need to exercise regularly and watch your diet. Avoid high fat food and sugar, carbonated drinks, excess caffeine. If you smoke then quit smoking, and avoid excess alcohol.
Q. I'm 30 yr old man, my ultrasound report suggest I have fatty liver, what does that mean? What precautions one should take esp in diet? Asked by: Himanshu
A. Fatty liver is caused either due to alcohol or if you are a non drinker then due to insulin resistance associated metobolic syndrome. You need to test for Diabetes and cholesterol. You need to exercise regularly (1/2 hr of aerobic exercise), avoid high fat food. Stick to low carbohydrate, low fat , high fiber and good protein diet. Avoid sugars, pepsis/cokes etc, fried and oily food, pizzas/burgers/samosas etc.
Q. I have done following test related to liver and other things and below is there results. what do u suggest after seeing this. T alkaline phosphatase photometry 67 u/l bilirubin - total photometry 0.8 mg/dl bilirubin -direct photometry 0.25 mg/dl bilirubin (indirect) calculated 0.55 mg/dl aspartate aminotransferase (sgot ) photometry = 40 u/l alanine transaminase (sgpt) photometry 60 u/l gamma glutamyl transferase (ggt) photometry 23 u/l protein - total photometry 7.7 gm/dl albumin - serum photometry 4.46 gm/dl serum albumin/globulin ratio calculated 1.38. Asked by: Sandeep
A. SGPT is elevated rest normal. You need to avoid alcohol. Get tested for HBSAg, HCV antibody and get an ultrasound upper abd. Based on that further investigations and treatment will be required.
Q. What are the symptoms of a typical hepatitis B positive person? Asked by: Harvey Dent
A. Acute hepatitis B causes jaundice, severe weakness, sometimes abd pain, nausea and decreased appetite. This may last for 6-8 weeks. Chronic Hepatitis B causes fatigue, decreased appetite or no symptoms at all. Hepatitis B carrier state causes no symptoms.
Q. 4 years back, I have a taken a Rapid Vaccination Course for hepatitis B of 0, 1 and 2 Months. Some people suggest that a Booster dosage after 12 months is required for the Rapid Course. Or Else, you have to repeat the whole course. Is it true? There are conflicting opinions. Asked by: Kumar
A. You can get a test for Hepatitis B surface antibody. If titers are above 10 iu/ml then you have protective antibodies. If not then you may need a repeat course.
Q. Recently, I had a TMT test for which the Hair on the Chest was Shaved by a Razor (Blade was new). There was no cuts made on the skin. Are there any chances of hepatitis B Infection with Razor being the same, but blade being new. Asked by: Prakash
A. The transmission will happen only if there is blood contact. So it is not likely from the razor handle but by infected blade only.