What leads to a higher risk of liver diseases in youth and younger adults?
Although the number of patients in the childhood and young adults who present with hepatitis have increased this year as compared to the last 2 years, they are still lesser then what we used to see before the covid pandemic set in. One of the reasons why we have still not seen the number of hepatitis cases as high as we had seen in the pre covid pandemic is people are by and large more conscious about the hygiene and therefore are more particular about the safety that they take while eating and are avoiding unhygienic places because of the fear of the pandemic and the habits which people have developed over the last 2 years.
Although the covid restrictions have been eased up and people have started moving out and have started consuming street food, they are still not doing it to the same extent as it used to happen before the covid pandemic set in.
The hepatitis cases that we are seeing nowadays are more in adolescent and young adults, the population which are least affected by the covid pandemic and who are in the habit of maximally eating street foods and are the most socially & sexually active. Most children with acute hepatitis are actually asymptomatic. A large proportion of children will just develop anorexia, vomiting and may be 1 or 2 days of fever and then their symptoms will disappear in 2- 3 to 4 days, some children will develop jaundice which will last for 4 to 7 days and will improve spontaneously after that. Less than 1 percent of children will go on to develop the severe form of hepatitis and liver failure. This is more common in adults who get hepatitis A. Unlike adults who develop symptoms for many days and the jaundice is often prolonged, most children will have very mild symptoms or no symptoms.
What are the effective treatments and therapies currently available?
What we need to do to prevent hepatitis is for Hepatitis A and Hepatitis E, is washing our hands frequently before consuming meals and consuming any form of food, ensuring that we drink clean and hygienic water and food and avoiding using reusable utensils in public gatherings. For Hepatitis B, there is an effective vaccine which is available and for Hepatitis C, we should ensure that people follow safe sexual practices, they do not indulge in sharing of needles, razors or any sharp equipment’s. Avoid IV drug use and maintain a healthy lifestyle, have balanced food and exercise regularly. With these measures you can prevent all forms of hepatitis. Another important way to prevent hepatitis is to ensure that one doesn't consume alcohol.
What symptoms do children and adults show, are the symptoms different for children and adults?
Alcohol consumption is increasing in younger people and today this has become one of the important causes of hepatitis in young adults who present with jaundice, bloating, swelling of face, anorexia, vomiting and pain in the right upper half of the abdomen. They are much more prone to injury because they tend to binge drink and often neglect the consumption of food when they are drinking heavily. If we can prevent alcohol habit formation in this age group most of the people who develop alcoholic liver disease later on and develop hepatitis in the young adulthood can be kept safe.
How effective is stem cell therapy for liver cirrhosis?
Young adults are the highest consumers of street food, are socially and sexually active and also are enthusiastic travellers making them vulnerable to food-borne liver diseases like Hepatitis A and E and sexually transmissible liver diseases like hepatitis B & C. Children can also get hepatitis B from mothers who have hepatitis B. However, this can be prevented in most by an ante-natal screening of the mother and giving zero doses of hepatitis B vaccine and Immunoglobulin to the new born baby at birth within 24 hours. Most children with hepatitis remain asymptomatic. Some others will develop jaundice associated with fever, anorexia, nausea and vomiting for a few days and recover spontaneously. Around 1 per cent will develop severe disease and acute liver failure and the earliest way to predict this is prolonged INR of more than 1.5. Adults with Hepatitis A and pregnant women with Hepatitis E are at higher risk of developing liver failure. Vaccine is available for Hepatitis A and B but not for Hepatitis C or E.