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Indian Express
05-08-2025
- Health
- Indian Express
WHO classifies Hepatitis D as cancer-causing: Why taking the Hepatitis B vaccine helps
The World Health Organisation (WHO) recently announced the reclassification of hepatitis D as cancerous, emphasising the urgency for preventing viral hepatitis, which is a growing public health crisis. 'Every 30 seconds, someone dies from a hepatitis-related severe liver disease or liver cancer. Yet we have the tools to stop hepatitis,' Tedros Adhanom Ghebreyesus, MD, WHO Director-General, said in an official news release. The WHO's announcement stems from the International Agency for Research on Cancer's (IARC) reclassification of hepatitis D as carcinogenic, supported by data from a study published in 'The Lancet Oncology., 'In India, the prevalence of hepatitis D, caused by a virus, is low in the general population but may be underestimated in high-risk groups such as intravenous drug users and those with chronic hepatitis B. Public education on safe blood usage, avoidance of needle-sharing and safe sex practice like using barrier contraception prevents transmission,' says Dr Piyush Ranjan, vice-chairperson, Institute Of Liver Gastroenterology & Pancreatic Biliary Sciences, Sir Ganga Ram Hospital, New Delhi. Why hepatitis D is considered carcinogenic All types of hepatitis are associated with acute liver infection; however, only hepatitis B, C, and D can lead to chronic infections with a higher risk of liver cirrhosis, failure or cancer. According to the authors of the study's findings, hepatitis D is associated with a two- to six-fold higher risk of liver cancer compared with hepatitis B. Hepatitis D is a serious liver infection caused by the hepatitis D virus (HDV). However, it is an incompetent virus that requires hepatitis B virus (HBV) for replication. This means it cannot cause infection alone and triggers co-infections only with the hepatitis B virus. So hepatitis D only affects people who already have hepatitis B either simultaneously or sequentially. Hepatitis B & D co-infection runs a more severe course for risk of cirrhosis and liver cancer. Hepatitis B can cause liver cancer even without causing cirrhosis as it gets integrated in the DNA of cells. Hepatitis D virus augments the carcinogenic effect of Hepatitis B. As per the data, 75 per cent of hepatitis D patients could develop liver cirrhosis within 15 years. People who have contracted hepatitis B alone are 50 per cent less likely to develop liver cancer as compared to people who have hepatitis B and D coinfection. What is the mode of transmission? The mode of transmission is similar to hepatitis B and C, that is through parenteral route or injections and transfusion, mother to child transmission and sexual contact. How is hepatitis D diagnosed? A blood test (HDV-RNA test) shows antibodies. How can we prevent Hepatitis D? Universal hepatitis B vaccination indirectly prevents hepatitis D. Despite hepatitis B being included in the national immunisation programme, the vaccine coverage is a dismal 50 per cent. Managing infections among those already affected remains difficult owing to the limited availability of approved therapies, although emerging options like bulevirtide give an assurance. The carcinogen tag is expected to enhance global surveillance, funding and research to reduce the burden of HDV-related liver cancer. Prevention also relies on safe blood bank practices, safe sex, screening and avoiding needle sharing. How to take the Hepatitis B vaccine? Hepatitis B vaccine may be given in any of the following schedules: Birth, 1 and 6 months; birth, 6 and 14 weeks; 6, 10 and 14 weeks; birth, 6, 10 and 14 weeks. In catch up vaccination, use 0, 1 and 6 months schedule. An adult, especially if in a high risk comorbidity group, should take the hepatitis B vaccine in three shots. The second dose is given a month after the first, and the third dose is given six months after the second.
The Print
02-08-2025
- Health
- The Print
All about hepatitis D, deadly viral hepatitis given a ‘cancer' tag by WHO
Hepatitis D or HDV, which only affects individuals infected with hepatitis B, is associated with a two- to six-fold higher risk of liver cancer compared to hepatitis B alone, according to the IARC. Viral hepatitis, characterised by inflammation of the liver, can be caused by the five known hepatitis viruses—A, B, C, D and E. Among these, only hepatitis B, C, and D can lead to chronic infections that significantly increase the risk of cirrhosis, liver failure, or liver cancer. New Delhi: The World Health Organisation-International Agency for Research in Cancer (WHO-IARC) has now declared hepatitis D, a little-known but deadly viral hepatitis, as carcinogenic, expressing hope that this will lead to more screening and access to new treatments. It is estimated that globally, 48 million people are affected with HDV, which in combination with the hepatitis B virus, has the highest fatality rate of all the hepatitis infections, at 20 percent. Its prevalence is highest in low- and middle-income regions in Africa and Asia, apart from the Amazon basin and India. Scientific evidence has shown that 8-37 percent, depending on the region, of those infected with hepatitis B, also have HDV. A 2024 report by the WHO had said that India had over 3.5 crore cases of viral hepatitis—including 2.98 crore hepatitis B cases—in 2022, accounting for 11.6 percent of the total disease burden globally that year. Over 1.25 lakh people, the report suggested, had died due to hepatitis B and C in India that year. Senior gastroenterologists and public health professionals suggested that HDV is largely undetected in the country, mainly because of lack of screening, and is more prevalent in some parts of east India and among people infected with HBV. 'From a public health perspective, this classification by WHO-IARC highlights the importance of incorporating HDV awareness, screening, and prevention into the existing hepatitis B prevention programme,' Dr Saswata Chatterjee, gastroenterologist with the Calcutta Medical Research Institute (CMRI), told ThePrint. With liver cancer becoming a challenging burden, screening and early detection of co-infections, such as HDV, will be crucial in reducing chronic complications of viral hepatitis, he added. Also Read: Govt says no plan to ban heartburn drug ranitidine, carcinogenic impurities within safe limits HBV triggers rapid progression to end-stage liver failure Dr Piyush Ranjan, senior gastroenterologist with Sir Ganga Ram Hospital in Delhi, explained that HDV is a satellite virus that requires hepatitis B virus (HBV) for replication, causing the most aggressive form of viral hepatitis. Compared to hepatitis B and C, HDV leads to more rapid progression to cirrhosis and liver cancer. In clinical terms, explained CMRI's Dr Chatterjee, HDV occurs as a co-infection—when it is contracted simultaneously with HBV—or a superinfection—when an individual who is chronically infected with HBV becomes infected with HDV. While HBV increases the risk of developing liver complications, HDV increases this risk substantially, accelerating the progression of liver fibrosis, cirrhosis and malignancy. The mode of transmission of this hepatitis virus is similar to hepatitis B and C—through contaminated injections, mother to child, and sexual contact. Dr Vibhor Sharma, a medical oncologist with Asian Hospital, highlighted that co-dependency of HDV on HBV leads to making hepatitis worse in patients. 'HDV-triggered liver disease is more severe as it can result in end-stage liver failure in less than ten years,' he said, adding that as compared to the general population in India, this form of hepatitis is seen more commonly in intravenous drug users, HIV/AIDS patients and those with chronic HBV. The declaration by the WHO-IARC is crucial, said the medical oncologist as HDV, despite its aggressiveness in triggering liver cancers, is mostly undiagnosed and is grossly underreported in developing countries such as India. Prevention and management Clinicians say HDV is preventable at a low cost, through immunisation. The effective methods to prevent both HBV and HDV are the vaccines against hepatitis B, safe blood practices, sterilisation of medical equipment, and safe sex practices, said Dr Chatterjee. The HBV vaccine in India, as part of the Union government 's Universal Immunization Programme, was piloted in 2002-03 and then scaled up in the entire country in 2010 to protect children from the acute infection. It is now provided as part of the pentavalent vaccine at 6, 10 & 14 weeks apart from the birth dose of hepatitis B vaccine. However, a 2020 study from India said that although the coverage of third-dose hepatitis B vaccine has reached 86 percent in the country, the birth dose coverage was under 50 percent in 2015 despite high rates of institutional deliveries. The WHO says that while treatment with oral medicine can cure hepatitis C within 2 to 3 months and effectively suppress hepatitis B with life-long therapy, treatment options for hepatitis D are evolving. Sir Ganga Ram's Dr Ranjan maintained that for those already infected, management is challenging, with limited approved therapies, though newer agents like bulevirtide—an antiviral therapy especially developed against the condition—offer promise. 'The carcinogen tag will hopefully intensify global surveillance, funding, and research to curb the burden of HDV-associated liver cancer,' said the gastroenterologist. (Edited by Gitanjali Das) Also Read: Cancer warning on liquor bottles 'long overdue'. Even 'light', 'moderate' drinking poses threat
Hindustan Times
25-07-2025
- Health
- Hindustan Times
Gastroenterologist explains dangers of chronic acid reflux, shares 10 tips to reduce it: Lose weight, don't smoke
Is your mealtime triggering a sense of dread for you, because of the uncomfortable sensation that follows? After having a heavy meal, the tight fullness in the abdomen along with a burning sensation in the throat and chest happens to a lot of people. But when this is allowed to persist, it may turn into something more serious, like GERD (Gastroesophageal Reflux Disease). Acid reflux happens once in a while after a meal, not very serious, but when it occurs on a daily basis, then proper care needs to be taken. Acid reflux usually feels like a sour taste in the mouth with burning in the throat. (Shutterstock) ALSO READ: More than acid reflux? Doctor says how to spot hiatus hernia and how to treat Dr Piyush Ranjan, DM gastroenterology, senior consultant and co-chairperson, department of gastroenterology, Sir Ganga Ram Hospital, New Delhi, shared in an interview with HT Lifestyle what happens when acid reflux, which is a symptom, progresses into a chronic condition like GERD, and why it shouldn't be ignored. First up, he shared a basic breakdown on what acid reflux is and just how common it has become nowadays. 'Acid Reflux is one of the most common disorders of the digestive tract. 1 in 10 people get acid reflux almost every day. All of us have experienced this at some point of time in our lives. This condition occurs when the contents of our stomach, including acid, push back up into our oesophagus (food pipe). Long-term consumption of rich, greasy, spicy, non-veg food and oily food leads to acid reflux.' How is GERD different from acid reflux? Since acid reflux happens very often whenever someone eats a heavy meal, many people brush it off and simply pop in some antacids for quick relief. But if eating habits are not changed to address the problem of acid reflux, then it slowly becomes GERD (Gastroesophageal Reflux Disease), which is chronic. Clarifying the differences and pointing out the risk factors of GERD, the gastroenterologist elaborated, 'GERD is the chronic, more severe form of acid reflux. This can be really dangerous because it can actually cause damage to the lining of the oesophagus. Unhealthy lifestyle habits such as not eating breakfast on time or eating a late breakfast, eating late dinners, or having a large amount of gap between meals, excessive smoking and taking alcohol can cause it. Certain conditions, like obesity, hernia, may also increase the risk of GERD.' Heartburn is a symptom of acid reflux- which is a burning sensation in the chest.(Shutterstock) Heartburn is also a common symptom of GERD. Dr Rajan described the sensation of heartburn and said, 'Heartburn (burning sensation in the chest bone) is the most common symptom of GERD. People suffering from condition can also present symptoms such as bitter or sour taste in the mouth due to reflux of stomach contents, excessive salivation, extra esophageal manifestation, a sensation of lump in the throat, feeling nausea after you had a meal, regurgitation of food or sour liquid, loss of appetite, burping, bloating, stomach discomfort, upper abdominal pain, asthma, chest symptoms and dental problems. ' While on the surface acid reflux may seem manageable, certain symptoms should never be ignored, as Dr Ranjan noted, 'Alarming symptoms are weight loss, chest pain, dysphagia (difficulty in swallowing) and blood in vomiting. If any of these are alarming symptoms, the patient needs prompt evaluation by endoscopy." Dr Ranjan further emphasised what happens if it is left untreated for long. "If the symptoms occur more than three times a week, then it becomes GERD, as long-standing GERD can lead to erosive esophagitis, which is the inflammation that damages the tube running from the throat to the stomach. Barrett's oesophagus may arise and increase the risk of oesophageal cancer. If the condition is not managed by medicines, surgical options can also be considered,' he concluded. 10 tips to reduce acid reflux Certain lifestyle changes help in reducing acid reflux, and in turn, when this is controlled chances of acid reflux becoming chronic and turning GERD are significantly less. Dr Ranjan listed 10 tips to help reduce incidences of acid reflux: Small meals instead of heavy ones: Have small meals every four hours small meals, avoid every meal at a time. Break your meals up into small meals over the course of the day Meal and bedtime gap: There should be a gap of at least 3 to 4 hours between your dinner food intake and sleep time. Head angle when sleeping: During sleep, keep your head elevated for at least 35 to 45 degrees Correct sleep position: Try to sleep on your left lateral side as if you were sleeping on the left side, stomach being on the left side for most people would allow gravity to keep the acid that is produced in the stomach to remain in the stomach, reducing the chances of getting acid reflux Reduce weight: Maintain a healthy body weight-Pregnant women, people who are overweight or obese, can actually be more susceptible to GERD, so weight does matter. Avoid certain drinks: Refrain from consuming alcohol, Sodas, carbonated beverages, lemon water, pineapple, oranges, apple cider vinegar, mint, honey, coffee, chocolate and teas. These are all things that can increase stomach pressure and make symptoms worse as well. Say no to spicy and fried foods: Avoid fatty foods, spicy foods, deep-fried foods, and excessive sweets. Don't smoke: Don't smoke, as it can really worsen the symptoms of GERD. Eat slow: Eat food slowly and chew it thoroughly. Avoid wearing tight belts: Don't wear tight belts around your waist as it puts pressure on the stomach or tummy and causes the acid to come up and hit the food pipe, worsening acid reflux. Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
News18
23-05-2025
- Health
- News18
Booster Shots Crucial For High-Risk People, Waning Immunity Fuels COVID-19 Surge: AIIMS Professor
Last Updated: India's resilience against Covid-19 depends on several factors - widespread prior exposure to the virus, extensive vaccination coverage, and ongoing public health monitoring. Booster doses may not be urgently needed for the general population, but they are crucial for the elderly and medically vulnerable, as waning immunity emerges as a key driver behind the latest global COVID-19 surge, Dr Piyush Ranjan, professor at All India Institute of Medical Sciences (AIIMS), told News18. As several parts of Asia grapple with a fresh surge of COVID-19 cases, India stands relatively unshaken. Countries such as Singapore, Hong Kong, Thailand, and China have witnessed a sharp rise in infections driven by the highly transmissible Omicron subvariants LF.7 and NB.1.8. 'Despite the latest virus's enhanced ability to spread, India's COVID-19 situation remains stable, with only a mild uptick in cases reported as of mid-May," said Ranjan, a professor, Department of Medicine, AIIMS New Delhi. Ranjan – who has published various studies in peer reviewed journals to assess the impact of Covid-19 – believes that booster doses, particularly those targeting Omicron-related variants remain effective in reducing severe disease, hospitalisation, and death, though they are less effective against mild or asymptomatic infections. 'Given the mild nature of current cases and the absence of a significant surge in India, booster doses for the general population are not urgently necessary but should be encouraged for those who have not received a booster in over a year, as waning immunity is a key driver of current surges," Ranjan said. 'Updated monovalent vaccines targeting JN.1 or closely related strains are expected to offer protection against severe disease caused by LF.7 and NB.1.8," he added. According to Ranjan's analysis, in Singapore, ICU admissions have slightly declined, which is an encouraging sign that while more people are falling ill, most are not experiencing severe disease. 'The common denominator in these regions is the rapid spread of LF.7 and NB.1.8, subvariants descended from JN.1, which in turn emerged from the BA.2.86 lineage of Omicron," he said. These subvariants, he said, carry mutations that allow them to evade immunity more effectively, leading to increased transmission – even among those previously infected or vaccinated. 'However, while their spread is swift, the symptoms remain largely mild: sore throat, low-grade fever, fatigue, and occasionally nausea or diarrhoea," Ranjan said. India's numbers tell a calmer story, he said, based on the May 19 data, which recorded just 257 active COVID-19 cases nationwide, primarily concentrated in Kerala, Maharashtra, and Tamil Nadu. Unlike the sharp spikes observed abroad, India's increase has been described as 'under control." 'Most patients have reported only mild symptoms and have recovered at home without the need for hospitalisation or advanced medical care." Ranjan attributes India's resilience to several factors, saying, 'Widespread prior exposure to the virus, extensive vaccination coverage, and ongoing public health monitoring are the main reasons. However, there is a caution against complacency, especially for vulnerable groups such as the elderly and those with underlying health conditions." Globally, the World Health Organisation (WHO) has categorised LF.7 and NB.1.8 as Variants Under Monitoring, not Variants of Concern, underscoring that while these subvariants warrant attention, they do not currently pose a significant global health threat. Be cautious, not fearful To avoid unnecessary alarm while maintaining readiness, he believes in educating the public about mild symptoms instead of imposing 'blanket restrictions that could spark panic." 'Focus on educating the public about mild symptoms, the effectiveness of vaccines, and the importance of protecting vulnerable groups. Use trusted channels to counter misinformation," he said. 'Encourage voluntary measures like mask-wearing in crowded indoor settings, hand hygiene, and respiratory etiquette, particularly during travel or large gatherings," he said while adding that the government 'must avoid mandatory restrictions unless severe cases rise significantly," he added. As the virus continues to evolve, he believes, the government must ensure that hospitals are prepared for potential localised increases in admissions, particularly in states like Kerala and Maharashtra, without overhyping the risk. 'India's current low case load suggests existing capacity is sufficient. These measures align with the current mild nature of the surge and the effectiveness of existing vaccines, focusing on protecting the vulnerable while maintaining normalcy," Ranjan said. 'The public is urged to remain cautious but not fearful," he said while adding that 'India's robust surveillance and vaccination infrastructure provide a strong foundation to manage this wave without alarmist responses." tags : coronavirus covid vaccine covid-19 Location : New Delhi, India, India First Published: May 23, 2025, 10:37 IST News india Booster Shots Crucial For High-Risk People, Waning Immunity Fuels COVID-19 Surge: AIIMS Professor
