Wednesday, July 24, 2013

Large numbe of people in South Kashmir infected by Hepatitis

Many people in South Kashmir has been infected by the hepatitis C virus (HCV) and is causing many challenges namely (i) catastrophic mode of spread of this agent, (ii) colossal future health problems of the infected persons and (iii) danger of secondary spread of infection to rest of the Valley.

Over the years HCV infection has kept a low profile in Kashmir. Prevalence of HCV in healthy blood donors has been consistently around 0.4%. In late 2012 & early 2013, there was a surge of HCV infections from 2 villages in Anantnag District.

Hepatitis C Virus, genotype 3a, is the main cause of the problem. One third (30%) of the population is chronically infected with the virus. This means that around 2,700 out of the 9000 population of these 2 villages are infected. Eighty-six percent of those infected have hepatitis C virus in the serum samples tested and had elevated liver tests indicative of chronic viral hepatitis. HCV viral load ranged from thousand to million viral copies per patient.  Infection is prevalent mostly in children and young adults and equally distributed in both sexes. It is estimated that 400 children, 1300 women in the childbearing age and 600 earning men are infected.

Most of those infected have no symptoms (Silent Killer). Chronic HCV is a progressive liver disease and it is estimated that around 20 percent population infected shall develop Cirrhosis & End Stage Liver Disease & liver failure in next one to two decades. Amongst cirrhotics, liver cancer occurs at the rate of around 1 to 4% per year. Thus if untreated we might face an unprecedented situation with hundreds of patients with liver failure and liver cancer and most of these patients will include young bread earning men, pregnant mothers and children. Second, HCV will continue to spread to unaffected population of these villages and this will particularly strike fetuses of pregnant mothers, neonates, and young children. These patients might become a source of infection for health care workers, rest of State population and parts of North India as many men travel to Punjab and Haryana in winters for work.

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