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Thursday, January 24, 2008

Prevention of liver diseases

Prevention of liver cancer
Prevention of liver cancer is possible at two levels. The first level of prevention is to avoid alcohol abuse and to prevent the occurrence of Hepatitis B or Hepatitis C. These are acquired from infected individuals via blood or rarely other secretions, by sharing of infected needles among drug addicts, or by the sexual route. Their transmission can be avoided by use of disposable needles in hospitals, by strict and universal screening of all blood donors in blood banks and refusing donations from infected persons. The spread of Hepatitis B can be curbed by universal vaccination of all newborns and the rest of the non-infected population.
The second level of prevention is in patients who have liver cirrhosis. A significant proportion of them will develop cancer. This can be avoided if they undergo a timely liver transplant and the diseased liver can be removed. All those with cirrhosis should see a liver specialist to find out if a liver transplant is suitable for them.
Prevention of cirrhosis
The three common causes of cirrhosis i.e., alcoholism, Viral Hepatitis B and C are all preventable as is described for the first level of prevention in liver cancer. However, at times, cirrhosis may result from genetically determined diseases such as autoimmune hepatitis, metabolic disorders (for eg. Wilson's disease and others, especially in children), primary biliary cirrhosis and primary sclerosing cholangitis which cannot really be prevented.

Preventing the spread of viral hepatitis
Proper hygiene is the key to preventing the spread of many diseases, including Hepatitis. Other preventive measures include:
Vaccinations - A Hepatitis B vaccine is routinely given to toddlers as part of their immunization schedule. A hepatitis A vaccine is available for people at risk for contracting the disease while traveling. (There are no vaccines for hepatitis C, D, or E at this time.)
Blood transfusion - Blood products are routinely screened for Hepatitis B and C, and HIV, to reduce the risk of infection from transfusion.
Antibody preparation - If a person has been exposed to Hepatitis B, an antibody preparation can be administered to help protect them from contracting the disease.
The prevention of Hepatitis B and C should be aimed at the high risk groups and situations which are

a) Unsafe Blood transfusion,
b) Hepatitis B or Hepatitis C in the family,
c) Surgical procedures or dental manipulation,
d) intravenous drug abuse,
e) Unprotected sexual exposure,
f) Dialysis,
g) Medical or paramedical personnel.

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