Achieving zero infection in newborns can make India hepatitis B-free

PUNE: In a country like India where vaccination against hepatitis B is less than satisfactory, preventing every new infection caused by mother-to-child transmission can help eradicate the disease, say experts.

“Hepatitis is often latent but can become a fatal disease and one of the most common ways of infection is through an infected mother. We strongly advocate and practice ante-natal screening and vaccination of hepatitis B-positive mothers and provide vaccination to the newborns," said hepatologist Harshal Rajekar, Columbia Asia Hospital, Pune.

Newborns who remain outside the ambit of vaccination are more prone to develop chronic hepatitis B – estimates show that infants are more prone to develop chronic infection as opposed to under-five children and children above five years of age, he added.

Elaborating, Rajekar said, "Chronic hepatitis B infection acquired in childhood carries a 25 per cent risk for development of chronic liver disease, cirrhosis or hepatocellular carcinoma (the most common type of primary liver cancer that occurs most often in people with chronic liver diseases caused by hepatitis B infection). That is why vaccinating newborns with an aim to achieve zero infection in the segment is critical to eradicate the disease from the country by 2080."

Hepatitis refers to the inflammation of liver and can be self-limiting or progress, causing liver fibrosis (scarring), cirrhosis or liver cancer. The virus is transmitted through contact with blood or other body fluids of an infected person. As per latest estimates, India is home to 40 million people who are chronically infected with hepatitis B. Incidentally, more than 80 per cent children in Pune aged between 12 and 23 months have not received 3 doses of hepatitis B vaccine, government data show.

India has traditionally been a high endemicity area when it comes to hepatitis B and to protect the susceptible host by immunization is the most effective strategy. The National Viral Hepatitis Control Program (NVHCP) makes it an imperative to screen pregnant women for hepatitis B in areas where institutional deliveries are less than 80 per cent to ensure they are referred for institutional delivery for birth dose hepatitis B vaccination.