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."