What we see is only a small part of the patient’s world

A national awareness and testing campaign will take place throughout the week within the framework of World Viral Hepatitis Day, which will be observed tomorrow, Friday 28 July. Dr. Daniela Basso (MP 35259) is a member of the Argentine Society of Hepatology (SAHE), which has launched a hepatitis C testing campaign that includes free testing without prior appointment at 68 testing sites in 18 provinces of the country.

“Viral hepatitis is a group of diseases with an infectious cause, in this case caused by a virus. There are different types of viruses: A, B, C, D, E, etc. Some viruses can cause inflammation of the liver, even if the liver Not the main organ affected. The pictures can be acute or chronic and can have very different manifestations from each other. Some patients may be asymptomatic, while others may develop fulminant hepatitis to the point of requiring transplant,” Dr. Basso first explained health science.

At the same time, he recognizes that now is an opportune time to raise awareness, in line with the World Health Organization (WHO) goal of setting precisely this date as “Talk about hepatitis”.

How dangerous is hepatitis when the liver has no symptoms?

The danger can be in two ways, the first is to get sick without knowing it, which is a waste of time, because the disease progresses more or less quickly in its chronic form, and the patient may develop cirrhosis or cancer of the liver, which is It does have a high mortality rate and social hazards. and economic impact. So it’s ignoring that a person has it. The other problem is that you spread it unintentionally, causing the disease to spread, and maybe the infected person doesn’t respond, but it happens to the infected person.

How to detect and control?

It is important to know that there are steps you can take to avoid getting hepatitis. We have vaccines for hepatitis A and hepatitis B. Everyone over the age of 18 should be tested for hepatitis C at least once in their life. It’s also important to remember that the hepatitis B vaccine is universal, free, and comes in three doses for adults. Pregnant women who receive their first dose in the last trimester of pregnancy should remember to complete the full course of treatment. Hepatitis A vaccine has been included in the vaccination record since June 2005, and it is given at the age of one. Adults without protective antibodies should be vaccinated by prescription, and two doses are required. Pregnant women cannot get the hepatitis A vaccine.

What measures must we take to avoid contagion?

It depends on the agent. Of the viruses that cause hepatitis, probably the most important are A, B, and C. A has the form of oral-faecal transmission through contaminated food or water. From there we can see what we can do if we want to shorten the transfer cycle. Namely hand hygiene, food hygiene, sewage management, access to safe water, vaccinations. Since June 2005, one-year-old children have been supplemented with hepatitis A vaccine. Adults, especially those at risk, also need to be vaccinated, which is done with a medical prescription. These patients are immunosuppressed patients, patients on dialysis, and patients with HIV or other liver diseases. Hepatitis B and C are transmitted from mother to child through blood and sexual relations, the method of prevention is vaccination against hepatitis B, use of condoms, trying to detect patients in time, treat them early, and prevent the damage from progressing.

What is the prevalence of hepatitis in the office?

The scope is relatively wide, because we not only accept consultations from patients in this city and the region, but also consultations from patients in other provinces. This is not common, in fact the prevalence of hepatitis B and C is very low, only 1% in Argentina according to our records. But this topic is always mentioned during consultations. Even if it is fatty liver, we have to do blood tests to find out who is sick and who needs to be vaccinated. At least place an order and talk about it.

When does a patient enter the waiting list for a liver donor?

A person has two conditions on the waiting list, generally the first is cirrhosis where the liver is not working, decompensated cirrhosis, this can be due to alcohol consumption, viral diseases, autoimmune hepatitis, etc. caused. .. Another reason is the so-called acute liver failure (fulminant hepatitis), healthy patients, such as taking certain drugs, will be poisoned and cause liver failure. There are other conditions that lead to transplant, but they are rarer and less frequent. According to Incucai’s 2021 data, about 1,500 people are waiting for a liver transplant, of which 418 received a transplant, up from 422 last year.

What collaborations do they have with other health professionals?

Possibly (hepatitis testing) is not routinely required and that would be an important modification, yes there are many colleagues especially clinicians and gynecologists who also play an important role by screening pregnant patients for hepatitis B. In the office, I’ve seen patients with serology, but I think we’re seeing a small slice of the patient’s world, and I don’t think it’s so ingrained in other colleagues to prescribe it. That’s one of the intentions when we run our campaign, we have other mediums to spread the message, we can reduce transmission and reduce the prevalence of disease. The World Health Organization has a goal of having no hepatitis by 2030, and we may not be able to achieve that because of the setbacks we’ve had with the pandemic, and we don’t have a lot of resources. However, our goal is to reduce the number of patients and our patients will not become so severe.

Why are there so few hepatologists and only three in Rio Cuarto?

Really, I don’t know. There are not many in the country. Most are concentrated in big cities. In any case, in Córdoba we are not that bad if we compare with other inland provinces, we have a great advantage because we have two transplant centers: the private hospital and the Sanatorium of Allende; and the public Fields of Cordoba Hospital. We also work as a team, we get along very well, and we have important connections with these centres. The situation is very different in Patagonia and northern Argentina, where resources are much smaller.

What activities will you do for this event?

The aim is to give people an easy way to understand what hepatitis is, what we can do to prevent it and take advantage of vaccination. The country made huge sacrifices to make the hepatitis B vaccine universal, providing 3 doses of the vaccine to everyone who wanted it, and the hepatitis A vaccine to children and high-risk groups.

What is your role in the Argentine Society of Hepatology (the association you belong to)?

In the Argentine Society of Hepatology we have representatives from the city, now I have to be in charge, but before Dr Carlos Mendoza, in fact we had a liver unit at the Rio Cuato Medical Institute, we have the same The Liver Unit is concerned with presenting the activities of the association in the city and towns of the region.

What will they do on social networks and in the region?

We will pass the information on to our colleagues via social networks to help us find patients. Sometimes it doesn’t always take an expert to do it. There are a lot of doctors who are very dedicated and also have hepatitis issues, and I’ve seen that in seeing patients. In addition to the dissemination, there is a very interesting project that will take place in the town of Elena during the week of August 14th to conduct a hepatitis C detection campaign and a diabetes survey, so we have provided the all information.

Fernanda Bireni