Hepatitis B and Liver Cancer: Strategies for Prevention and Screening

Hepatitis B is a type of virus that can cause severe liver infection with serious complications such as liver cancer. Liver cancer, especially hepatocellular carcinoma (HCC), is the second most prevailing cause of cancer-related deaths, wherein Hepatitis B is responsible for over 50% of HCC cases. However, with suitable preventative methods and timely screening, the effects of Hepatitis B-related liver cancer can be significantly reduced.

Screening Strategies

1. Testing and Diagnosis: Hepatitis B screening includes blood tests to identify hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and hepatitis B virus DNA. These tests help identify people with chronic hepatitis B infection and guide further treatment.

2. Regular Monitoring: Individuals with chronic hepatitis B should have their liver function tests, viral load, and alpha-fetoprotein (AFP) levels checked regularly to detect any signs of liver damage or progression to liver cancer.

3. High-Risk Populations: Screening should be prioritised for people born in hepatitis B-endemic areas, those with a family history of liver cancer, and those with a history of injectable drug use or multiple sexual partners. Healthcare practitioners must also be diligent in recognising at-risk persons and prescribing appropriate screening procedures.

4. Primary Care Integration: Integrating hepatitis B screening into routine primary care settings can enhance access and early detection. This can be accomplished by developing standardised screening techniques and ensuring proper follow-up for people who have chronic hepatitis B infection.

Prevention Strategies

1. Vaccination: The most effective preventative method against Hepatitis B is vaccinations. It is recommended that all infants take the hepatitis B vaccine as part of their regular vaccination schedule. Individuals at high risk, including healthcare workers, those with chronic liver illness, and those with several sexual partners, should also be vaccinated.

2. Mother-to-Child Transmission Prevention: During childbirth, an infected woman can pass Hepatitis B to her child. Comprehensive preventative services that involve early screening of pregnant women, antiviral medication for moms with high virus loads, and prompt vaccination of infants can greatly minimise mother-to-child transmission.

3. Safe Injection Practices and Blood Screening: Hepatitis B can be transmitted through infected needles, syringes, and blood products, secure injection practises and blood screening are critical. To prevent hepatitis B transmission, using sterile needles and syringes, promoting safe injection practices, and thoroughly screening blood and blood products is essential.

4. Awareness and Education: It is critical to raise awareness about Hepatitis B transmission, preventative techniques, and the significance of regular screening. Educational initiatives aimed at high-risk communities, healthcare providers, and the general public can help with hepatitis B identification and prevention.

Hepatitis B is a significant public health concern as it contributes to the high prevalence of liver cancer. The HBV infection can be minimised by taking efficient preventative measures such as vaccination, mother-to-child transmission prevention, safe injection practices, and public awareness. It is also essential to undergo regular screening for early detection and treatment of liver cancer, especially in high-risk patients. By implementing comprehensive preventative and screening techniques, we can lower the burden of hepatitis B and its associated liver cancer cases, saving lives and improving public health.

By Dr. A Satya Srinivas, Consultant, Medical Oncologist, HCG Cancer Centre, Vijayawada

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