If you ask any physician treating liver diseases what condition worries them most, they will certainly say: Hepatitis C. It is estimated that Hepatitis C infects more than 170 million people worldwide. This means three out of 100 people are chronically infected with the virus. In the UAE, we believe that the prevalence of Hepatitis C among the local population is less than the global average as we estimate it at one-two%. Among expats, the prevalence is around 2%.
Hepatitis C is a chronic disease with serious long-term consequences. The virus is slow in inflicting damage to the liver, but the damage is steady and cumulative. We typically see patients affected with liver cirrhosis after harboring the virus for 30-40 years and sometimes for even 50 years. However, having another factor that synergistically damages the liver can accelerate the damage. Factors include; alcohol abuse, fatty accumulation in the liver with resulting inflammation, HIV, abnormal accumulation of iron in the liver and Hepatitis B. Amongst Emiratis, Hepatitis C causes seven out of 10 cases diagnosed with liver cirrhosis. Six out of 10 patients who underwent liver transplantation did so because of it. Of every 10 patients diagnosed with liver cancer four of them are infected with the disease. So, no wonder that most of the budget allocated to liver patients goes to those infected with Hepatitis C. (In decompensated cirrhosis the annual cost of health care is estimated to be $60,000 to $80,000. If liver transplantation is considered, the cost of such an operation averages around $300,000. Annual post-liver transplantation costs treatments cost $10,000-$20,000. Treatment of liver cancer may therefore exceed $400,000.) Undoubtedly, the major loss from the disease comes from lives lost. Globally 300,000 to 350,000 people die every year because of the so-called ‘silent killer.’
How Can I Get Hepatitis?
Transmission of Hepatitis C depends on where you live. In industrial countries, the most frequent mode of transmission is through sharing drug-injection equipment. In Egypt where the disease prevalence exceeds 8 percent, infection was mainly transmitted through the use of inadequately sterilized needles in mass treatment of schistosomiasis prior to 1986. For the local population in the UAE, transmission occurred mainly through transfusion of blood products unscreened for Hepatitis C prior to 1992. Diagnostic tests for the infection was introduced in 1989. It was not until 1992 that blood products became Hepatitis C free. It is important to know that back in these days the major supply of blood products as imported from Europe and the USA.
Hepatitis C is a chronic disease with serious long-term consequences. The virus is very slow in inflicting damage to the liver, but the damage is steady and cumulative. We typically see patients affected with liver cirrhosis after harboring the virus for 30-40 years and sometimes even 50 years.
– Dr. Mohamed Al Zaabi Consultant Gastroenterology & Hepatology, Zayed Military Hospital, Abu Dhabi
Other important routes of transmission may include:
- Being born to a mother infected with Hepatitis C
- Sharing intravenous drug equipment and even snorting crack cocaine.
- Activities such as body piercing, acupuncture, tattooing or public shaving
- Having medical or dental procedures
- Undergoing haemodialysis
- Organ transplantation from an infected donor
- Thalassemia, sickle cell anaemia, and haemophilia patients are at increased risk of acquiring the infection through frequent reception of blood products
It would be great if there was a vaccine against Hepatitis C to prevent its transmission. Sadly, such a thing is non-existent. Few measures can be made to prevent household disease transmission if a member of the family is known to have the infection. Any utensils that can injure the patient should not be shared with any other person. The good news about Hepatitis C though came in the last couple of years with the introduction of several highly effective, very tolerable, short duration oral medications that can cure patients completely from the infection. These medications are perceivably expensive. But if cost effectiveness is calculated in the right way, we will not only save money in the mid- and long-term, but more importantly we will be saving many lives and improve the quality of life of many others.