In a pioneering effort, Dr Manish Kak Gastroenterologist, from Columbia Asia Hospital, Ghaziabad has cured a patient having a co-infection of both Hepatitis B (HBV) and Hepatitis C (HCV). The patient, Suresh Marshall’s family members were greatly relieved and thanked the hospital, as he completed successful treatment of more than six months.
The 59-year-old Marshall had been diagnosedearlier in the same hospital for breathlessness. During the course of his treatment back in December 2014, liver damage was detected due to presence of Hepatitis B and Hepatitis C viruses. Marshall was advised immediate medical management, but unfortunately, he did not return to the hospital for almost a year.
In December 2015, the patient came back to Columbia Asia as he had been experiencing fainting spells twice or thrice a month. He was getting treated for this at a Delhi hospital, but anti-viral treatment was not considered there. After examining Marshall, Dr Manish Kak ordered a series of investigations to assess the impact of Hepatitis B and C (HBV, HBC) viruses. The patient was found to have advanced liver damage.
“I had discussedthe disease status with the family earlier also and hadsuggested evaluation and treatment. However, the patient did not take the advice seriously. When both HBV and HCV coexist, the liver damage gets multiplied, and this causes cirrhosis and hepatic coma (fainting when toxins reach the brain). The doctors who had treated him over the last one year only prescribed medicines to prevent fainting, but did not discuss with the family the pros and cons of treatment of HBV and HCV, to tackle the root cause of the problem,” said Dr Kak.
After diagnosis of the co-infection, the doctor decided to initiate the treatment in progressive stages, so that there was no detrimental effect on the patient body. In January 2016, Marshall’s medical treatment for Hepatitis C started and lasted for six months. The treatment for Hepatitis B started in May 2016. Finally, in July, the Hepatitis B DNA and Hepatitis C RNA were found to be zero indicating that the patient has been cured of these two viruses.
HBV and HCV infections account for a substantial number of liver diseases worldwide. As these two viruses share similar modes of transmission, co-infection is possible. According to the World Health Organization, approximately 350 million people are infected with HBV, and 170 million are affected with HCV.
“Treatment of HBV/HCV co-infected patients represents a challenge. No standard recommendations exist for such co-infection, and therefore, treatment must be individualized based on patient variables such as hepatitis blood test results, the patient’s prior exposure to antiviral treatment, and the presence of other similarly transmitted viruses. We have ensured that post this treatment; any further damage will be prevented. There is no reason to worry right now. Marshal is feeling better now, his ascitis is controlled, no episodes of liver coma since last 6 months, appetite has increased and liver function tests have improved; sadly though, we were not able to reverse the liver damage which has already taken place due to lack of timely detection and treatment. However, if he opts for a liver transplant in the near future, chances of having a successful implant are now higher, as technologies are better.” added Dr Kak.
“Having both diseases causes more damage and leads to more severe liver diseases. It also poses an increased risk for progression to liver cancer. Such an instance of co-infection in the same patient, while possible, is difficult to heal. We congratulate Dr Kak for the wonderful job. This is an exemplary case of Columbia Asia’s leadership in hepatology,” said Gaurav khurana General Manger, Columbia Asia Hospital, Ghaziabad.