Hepatitis: the silent killer

[PHP Nepal Vol 3 Issue 7 July 2013] | Three years ago, I officially started my public health journey in Arizona with a non-profit organization called the Asian Pacific Community in Action (APCA) whose mission is to “Improve the health and well being of the Asian Pacific Islander community through empowerment, health promotion, and disease prevention.”  My unofficial public health journey, however, started in February 2007 when I was informed that my dad in Kathmandu, Nepal had slipped into coma.

I immediately flew to Nepal from the United States in the middle of my semester at school.  Talking to the team of doctors in Nepal who were working on my dad’s case, I discovered that my dad was diagnosed with “Cirrhosis due to Nonalcoholic Steatohepatitis.” I had no idea what that meant.

In the process of assisting my dad navigate through his health complications; I traveled to few countries for medical consultations sometimes with my dad but most of the times with the piles of his health reports. I accumulated a wealth of knowledge about liver disease; cirrhosis in particular. Hepatitis is the leading cause of liver cirrhosis and ultimately leading to liver cancer.

Although July 28th is celebrated as “World Hepatitis Day” around the world, it still remains a disease unknown to many.  

Hepatitis simply means “inflammation of the liver.”  There are five different types of viral hepatitis – A, B, C, D and E.  Among these, B and C are the ones that are transmitted by blood and have the potential to cause chronic infections leading to liver disease and also cancer. 

According to Center for Disease Control and Prevention (2011), one in 12 individuals (approximately 500 million people) are infected with Hepatitis B or C virus globally.  The number of those infected with Viral Hepatitis is ten times higher than those infected with HIV/AIDS.  In Nepal, a total of 315,000 individuals are infected with hepatitis B virus,  240, 000 are exposed to hepatitis C virus of which 75, 000 have developed chronic conditions (Shrestha, 2010).

People infected with hepatitis, a silent killer, do not experience any symptoms but if left untreated, chronic viral hepatitis causes severe liver damage, liver cancer, and may lead to liver transplant cases for million unsuspecting individuals.

“Unfortunately, in some cases their liver disease is already so severe that I don’t have many treatment options beyond liver transplant,” says Dr. Mark Wong, a liver specialist with Banner Health Good Samaritan Hospital in Phoenix, Arizona, and also hepatitis B medical director for APCA. He further adds, “Most of the Asian Americans I see were probably infected in their native Asian countries and have been unknowingly carrying the virus for decades.”

APCA provides free preventive health screenings and services such as hepatitis B screening and vaccination, mammograms, diabetes testing, and tobacco prevention and cessation information among many other direct services designed to serve the Asian and Pacific Islander communities.  Among 250 individuals on average, who participate in APCA’s 8 different hepatitis B screening events spread throughout the year, at least 30 individuals are found to be infected with hepatitis B virus.

Often times, we find people’s world crashing down when they come to our events and find out that their test results for hepatitis came back positive. “I am going to die from this disease,” expressed a woman. There have been also some cases where people have stopped socializing or even stopped working from the fear of contaminating others with their newly discovered disease.  

Few facts to keep in mind about hepatitis B virus is that it does not spread through “casual contact” such as hugging or kissing, sharing utensils, holding hands, coughing or sneezing, or even through breastfeeding.  Hepatitis B virus only spreads when blood, semen, or other body fluids from a person infected enter the body of the one who is not infected through sexual contact or sharing needles, syringes, or other injecting equipment. Another way hepatitis B is transferred is from an infected mother to her baby at birth.

Although my dad was not infected with viral Hepatitis, his liver failure was caused due to the negligence and progression of nonalcoholic fatty liver disease also know as nonalcoholic steatohepatitis at its most severe stage; it did end up taking away his life in August 2009.  Since his passing away, my life hasn’t been the same.  It never will.

A simple blood test can detect chronic hepatitis infection, which leads to early diagnosis and effective treatment to suppress growth of the virus in liver.

Please take time to learn about this disease, get yourself screened, and confront other with the message that "Hepatitis is a silent killer".

Kamana Khadka is a Program Director of Asian Pacific Community In Action, Phoenix, Arizona, USA.

Milanchowk, Hemja,
Pokhara Metropolitan City, Ward No. 25,
Kaski 33700,
(+977) 061 400323