Year : 2011 | Volume
: 8 | Issue : 1 | Page : 1--3
Shivaram Prasad Singh
Department of Gastroenterology, SCB Medical College, Cuttack, Orissa, India
Shivaram Prasad Singh
Head, Department of Gastroenterology, SCB Medical College, Cuttack . 753 007, Orissa
|How to cite this article:|
Singh SP. Editorial.Hep B Annual 2011;8:1-3
|How to cite this URL:|
Singh SP. Editorial. Hep B Annual [serial online] 2011 [cited 2020 Sep 24 ];8:1-3
Available from: http://www.hepatitisbannual.org/text.asp?2011/8/1/1/190074
This issue of hepatitis B annual attempts to highlight hepatitis B virus (HBV) related issues which are often not dwelt upon in most published articles on hepatitis B.
In India, about 1-10% of health care workers are hepatitis B surface antigen (HBsAg) positive and health care workers especially surgeons and laboratory technicians are at a high risk of developing hepatitis B infection. Transmission from hepatitis B positive surgeons to patients has been well documented. Besides, the risk of transmission from a patient to a surgeon is also quite high especially following a needlestick injury from an hepatitis B e-antigen positive individual. In India, there is low awareness among health care personnel about hepatitis B vaccination and related issues, and no health policy in this regard. In relation to the health care workers, there is an urgent need to formulate guidelines on HBsAg testing, hepatitis B vaccination, restriction of the exposure prone procedures that can be performed, the extent to which their serological status can be revealed to patients, implementation of universal precautions, and postexposure prophylaxis. These issues are succinctly reviewed in the article "Hepatitis B and the surgeon" by Dr. Shailesh Sable, and Dr Aabha Nagral.
In the next article, "Management of Chronic Hepatitis B," the authors Dr. Rohit Goyal and Prof. Subrat Kumar Acharya have provided an extensive overview of the management of chronic hepatitis B (CHB) patients, emphasizing the need for identifying and treating patients at high risk of disease progression since effective antiviral therapy can arrest disease progression, reduce complications, and can potentially reverse liver damage if given for sufficient duration. The article lays stress on the need to timely initiate treatment with drugs that have high potency and high genetic barrier to resistance and ensure compliance once decision to treat is initiated. The article also highlights the importance of close monitoring of both treated and untreated patients for disease progression, and early intervention to prevent complications in those who show progression over time.
In the article "The intrafamilial occurrence of Hepatitis B virus infection and the profile of liver disease in close relatives of patients with HBV infection," Kavitha R and her colleagues from Calicut in Kerala have studied the prevalence of HBsAg positivity in family members of HBsAg positive patients, the profile of HBV infection in them, and possible risk factors in a close family environment. Besides, they also evaluated the burden of liver disease in these family members. They observed that the occurrence of hepatitis B positivity in family members of HBsAg positive patients was 14.53% which is 28 times more than the community prevalence of HBV infection in this region. Significantly, the study also found that brothers and sisters were more affected which could not be corroborated with vertical transmission, but could have been due to horizontal transmission. The study highlights the high occurrence of HBV infection in family members, and the urgent need for better counseling and vigorous screening of family members to identify asymptomatic cases in the community.
In this article: "Interferon for HBV infection: Plain or pegylated? Alone or in combination? Concurrent or sequential?" Prof. Ajit Sood and Prof. Vandana Midha have succinctly reviewed the current status of interferon therapy in the management of CHB, and advocated "tailoring" therapy for CHB patients. After reviewing the data available on a combination of interferon with nucleos(t) ide analogues including concurrent and sequential therapy, the authors have aptly concluded that at the moment there is insufficient data to recommend combination therapy.
In the management of CHB, selecting the optimum therapy for an individual patient can be a complex process because of the number of options that exist. Choice of therapy is likely to depend on several factors, including drug efficacy, the probability of sustained response, and the severity of liver disease, patient age, adverse events, associated resistance rates, and route of administration. In the article, "Telbivudine: A valuable treatment option in chronic hepatitis B," the authors, Prof. Shivaram Prasad Singh and Parimal Lawate discuss the current status of telbivudine in the management of CHB.
We hope that the articles published in this issue address important issues related to HBV transmission and management, and would enable health care providers to provide better care to patients with HBV infection.