Liver disease: Education key to better life quality

Liver disease: Education key to better life quality

The Asia-Pacific Association for the Study of the Liver (APASL)
has concluded its 15th conference with a number of breakthrough
treatments and updates on liver-related diseases being discussed.
The Jakarta Post's Emmy Fitri, invited by PT Roche Indonesia,
participated in the four-day conference held in Nusa Dua, Bali
from Aug. 18 through Aug. 21.

Novel medicines and breakthrough treatments being sought by
researchers and specialists all over the world would be futile if
public was not properly educated about the importance of health
issues.

But it would be worse if government health policy did not give
a clear indication of how health issues were to be managed.
Adequate information dissemination concerning prevention and help
centers, issuance of health insurance and access to hospitals
could only be achieved with strong political will and a
reasonable budget.

Preventive measures like maintaining hygiene, sanitation and a
healthy diet must be part of people's daily lifestyles -- basic
and affordable ways to remain healthy. But in some cases,
carriers of certain diseases, although have lived healthy
lifestyles, can still be contract ailments.

For special cases, people susceptible to getting certain
diseases must be aware of the need for early detections.

PT Roche Indonesia, for example, provides a toll-free hotline
for people curious to know about every aspect of hepatitis C. The
service can be reached on 0-800-140-3063. The company's president
director Ait-Allah Mejri said, "It's part of our commitment to
provide health education to the public."

Through education, he said, the public would be more aware of
their condition and could be critical of the services they get.

"We welcome the public to ask us any questions about hepatitis
C through this toll-free number," he said. The service was
launched last year during a commemoration to mark Hepatitis C
National Day on Sept. 16.

Meanwhile, Matei Popescu, Roche International's medical
director, said that a number of studies were underway to respond
to the enormous progress in the last 10 years for diseases like
hepatitis C, hepatitis B and also HIV.

Popescu mentioned among others, the Accelerate Study that
involved 1,400 patients in 132 centers in 15 countries. This
study aimed to see the most effective combination of medicines to
fight hepatitis C virus (HCV).

Another study was CHIPS, or Chronic Hepatitis C International
Pediatric Study, which involved 10,900 patients from 50
countries.

"We would like to see if the medication for adults can work as
effectively as it worked for children," Popescu said.

Hemophiliac children were prone to get HCV if the blood
donation screening was not properly done, he said.

Professor Chen Ding-shinn from Taiwan, who delivered a lecture
on state-of-the art immunization strategies for control of
hepatitis B in the Asia-Pacific region at the APASL conference,
stressed the urgency of immunization/vaccination to decrease the
mortality in cancer because of advanced or untreated hepatitis B.

Hepatitis B was transmitted mainly through blood transmission
such as maternal-infant or infected blood donations.

Newborns from mothers with hepatitis B must be given first
dose vaccines within seven days after birth and this vaccination
would give long-term protection.

"It is essential because worldwide there are 3 million people
dying every year of diseases that are preventable by vaccine,
including from hepatitis B," Ding-shinn said.

And the high cost of vaccine and immunization could be tackled
as there are 75 countries grouped in the Global Alliance for
Vaccine and Immunization. Among others, the goal of this alliance
was to give out hepatitis B virus (HBV) vaccines to people
susceptible to the disease such as intravenous drug users and
homosexuals.

Meanwhile Ali Sulaiman, hepatologist with Cipto Mangunkusumo
Hospital in Jakarta, mentioned how people living in riverine
neighborhoods were prone to get hepatitis E virus if they did not
pay attention to sanitation.

There was little data about outbreak of this water-borne virus
that directly attacks people's liver.

Ali gave 'old' data on two riverine towns of Sintang in West
Kalimantan and Bondowoso in East Java. The outbreaks in Sintang
took place in 1987 and again in 1991, while in Bondowoso it
occurred in 1998.

So far, the outbreaks had been contained, but he strongly
believed that many cases escaped health officials' monitoring
because physicians were generally not aware of this virus, and
could misdiagnose patients with hepatitis E virus with other
ailments.

A vaccine for hepatitis E had not yet been developed but Ali
said, "The only way to have this disease contained and not return
is through education."

"People wash and bathe in rivers and they also drink river
water without boiling it. Education therefore is the key to keep
away from this disease," he said on the sidelines of his
presentation on the outbreak of hepatitis E in Indonesia.

Radiologist Prijo Sidipratomo also emphasized the need for
public to be aware of an emerging disease called Budd Chiari
syndrome. Tracking the history of Budd Chiari patients, most were
females and who had been using oral contraceptives for years.

There was not yet any official data on how this disease was
contracted whose symptoms were similar to other liver diseases.
"I guess there are a number of patients who are diagnosed with
just liver disease but in this disease the function of the liver
increases and its excessive work can lead to liver damage and
also cirrhosis and death," he said.

Throughout Indonesia, there were only two clinics, according
to Prijo, that had the US$17 million MD CT (an advanced version
of CT Scan) which could give clear images of a damaged liver. The
two clinics were the Waringin Clinic in Central Jakarta and
privately run Gading Pluit Hospital.

Studies were ongoing to reveal the causes and the possible
ways of preventing it.

Elinor Levy and Mark Fischetti reached a perfect conclusion in
their new book The New Killer Diseases when they said, "More
research, a more dynamic public-health system and many of the
other steps we must take to improve our odds require greater
funding, much of it from government sources."

"That, of course, puts the fight against infectious diseases
in heavy competition with numerous other social and health-care
causes."