Hepatitis B, a major cause of liver cancer: Dr Shakil Gani

Hepatitis B virus is the leading cause of liver cancer in Bangladesh, accounting for nearly 66 percent of all liver cancer cases. 

About 10 million people in the country are carrying the virus, which is 5.4 percent of the total population.

Alarmingly, a large number of these people are unknowingly acting as sources of transmission.

Associate Professor and Head of the Hepatology Department at Dhaka Medical College (DMC) Hospital Dr ABM Shakil Gani discussed hepatitis prevention, treatment and public awareness in detail in an interview with BSS.

He said tests for Anti-HBc Total have shown that one in every three people in Bangladesh carries this antibody in their body. 

This means a vast number of people have been infected with the hepatitis B virus at some point in their lives, often without being aware of it.

Dr Shakil Gani noted that the prevalence of hepatitis C virus is comparatively lower. About 0.84 percent of the population—around 15 lakh people—are infected with hepatitis C, which is responsible for nearly 5 percent of liver cancer cases in the country.

Describing the reality of the healthcare system, he said that one out of every ten patients admitted to medicine departments suffering  from some form of liver disease. 

However, the hopeful aspect is that most liver diseases are preventable and, in many cases, completely curable, he said adding that another positive point is that almost all modern treatments for liver diseases are now available in Bangladesh.

Explaining hepatitis B and C, the hepatology department head said hepatitis, in medical terms, refers to inflammation of the liver. “Certain viruses primarily attack the liver, multiply inside liver cells and destroy them, causing the liver to gradually lose its normal function. Long-term infection can lead to liver cirrhosis, liver failure and even liver cancer. Two of the most dangerous such viruses are hepatitis B and hepatitis C,” he said.
 
Replying to a question on how hepatitis B and C spread, Dr Shakil said the viruses are mainly transmitted through blood and body fluids. 

These include the use of contaminated syringes or needles, unsafe blood transfusions, transmission from an infected mother to her child at birth, unprotected sexual contact, contact with open wounds of an infected person, use of non-sterilized instruments in dental treatment, and tattooing or body piercing, he said. 

Sharing needles of blood glucose testing devices can also spread the virus. However, he emphasized that hepatitis does not spread through sharing food, living together or normal social interaction, he said.

Regarding risks faced by healthcare workers, he said doctors, nurses, lab technicians and dentists are at higher risk than the general population due to frequent exposure to patients’ blood and body fluids. 

Statistics show that after a needle-stick or sharp injury, the risk of hepatitis B infection ranges from 23 to 62 percent, while the risk for hepatitis C is about 1.8 percent, he said adding therefore, hepatitis B vaccination is extremely important for all healthcare workers.

Speaking on the role of physicians in controlling hepatitis, Dr Shakil Gani said doctors play a crucial role by raising awareness among the general public about modes of transmission, prevention and the importance of vaccination, encouraging patients to inform family members without unnecessary fear or social stigma, ensuring regular follow-up for infected individuals over 40 years of age, ensuring hepatitis B vaccination for newborns and high-risk groups, promoting safe medical practices with disposable syringes and sterilized instruments, and ensuring early diagnosis and timely treatment to prevent complications.

On hepatitis B treatment, he said the notion that there is no treatment for hepatitis B is completely wrong. 

Like diabetes or high blood pressure, hepatitis B often requires long-term treatment, which helps prevent serious consequences such as liver cirrhosis and cancer, he said. 

However, indiscriminate use of steroid drugs can reactivate the hepatitis B virus and cause severe damage, he added.

Advising patients, Dr Shakil said those infected with hepatitis B must regularly consult liver specialists. 

He added that everyone above the age of 20 should take the hepatitis B vaccine, as three doses provide about 95 percent protection.

Dental treatment and surgeries should be done only by authorized and trained physicians, he added. 

“People should drink safe water, and anyone who has ever received blood or undergone major surgery should get tested for hepatitis C at least once. The good news is that hepatitis C is now completely curable with just three months of treatment, and the medicines are readily available in Bangladesh, he said.

Emphasizing the important role of physicians in controlling hepatitis, the DMC doctor said awareness must be created among patients and the general public about transmission, prevention and vaccination. 

He reiterated that hepatitis does not spread through eating together, social interaction or normal movement, and therefore fear or secrecy within families only causes harm.

He said hepatitis B and C are preventable diseases, and awareness, timely vaccination and safe medical practices can protect people from this silent killer.