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HindustanTimes Thu,23 Oct 2014

Long-term hepatitis can take nearly 20 years to surface

Menaka Rao, Hindustan Times  Mumbai, December 13, 2012
First Published: 01:15 IST(13/12/2012) | Last Updated: 01:17 IST(13/12/2012)

With no past history of major diseases, a concerned Ramadevi Vadnala, 43,  quickly signed up for some tests after she vomited blood during an illness in July. The doctors said she had hepatitis C. What’s more, they traced it to a blood transfusion she had undergone 20 years ago while pregnant with her son.

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“She would run the home singlehandedly without a domestic help. She would even insist on ironing my clothes. Now, she barely gets out of her bed, let alone the house,” said her husband, Gangadhar, who runs a medical store near their home.

The family was aghast when they were told that the treatment would cost nearly Rs. 3 or 4 lakh in the first year. “I had no option but to take the treatment forward. She means the world to me,” said Gangadhar.

The treatment costs include imported interferon injectibles — which in Vadnala’s case cost about Rs14,000 a week — in addition to oral tablets, and blood tests. Hepatitis B and C are viral infections that lead to inflammation of the liver. The illnesses often come as a complete surprise as infections take as long as 20 years to manifest themselves in symptoms.

“While about 70% of the patients infected with hepatitis B do not need treatment, most patients of hepatitis C do because they are chronically ill. This could cost them about Rs3 to 4 lakh a year including investigation costs. Many suffer from cirrhosis of the liver,” said Dr Abha Nagral, a consultant hepatologist at Jaslok Hospital who is treating Vadnala.

In the cases of both hepatitis B and C, the patient usually undergoes year-long treatment with interferon injectibles depending on the genotype of the virus.

“Patients can opt for cheaper interferon injectibles that cost about Rs60,000 a year. But studies show that the response rate in these injectibles is about 10% lower than in the imported ones,” said Dr Molina Khanna, a consultant gastroenterologist who practices in Borivli.

If hepatitis B patients do not respond to treatment, they need to be on life-long oral drugs, spending about Rs800 to Rs5,000 a month. In hepatitis C, though, the patient may have to look at joining clinical trials or find medicines abroad which can cost about Rs30 lakh a year.

In the last stages of hepatitis C, patients may need a liver transplant, particularly if a cancerous tumour has developed. This could cost anywhere between Rs8 lakh at a public hospital such as KEM, Parel, to more than Rs20 lakh in a private hospital in Mumbai or Delhi.


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