Reused injections, the main culprit of hepatitis C in rural India

Every year, in India, 3-6 billion injections are administered, of which 62.9 per cent are injected in an unsafe manner. In general almost half the population that walks out of a health facility has had an injection, no matter what the symptoms.

“Of all the injections given in India, many carry the risk of transmitting blood-borne viruses, because of the high use and the fact that a number of people administering these injections are often not trained medical practitioners.

Most people know about HIV and hepatitis B, but not many know about the hepatitis C virus (HCV). In fact, this is 10 times more potent than HIV,” says Dr PBSS Raju, Consultant Gastroenterologist and Hepatologist, Care Hospitals, Hyderabad.

An estimated 4.7 million hepatitis C virus infections can be attributed to poor needle practices—reusing needles, disposing them incorrectly, poor sterilization and incorrect usage. HCV is called a ‘silent killer’ as infection may not produce any symptoms for years and it is often too late when disease is discovered.

“The problem with that is that while the Hepatitis B virus (along with hepatitis A) has a vaccine available to prevent it, the Hepatitis C virus doesn’t. Worse, hepatitis C is asymptomatic for years (there are no obvious symptoms) and it usually reveals itself very late through more obvious symptoms (blood vomit, black stool, water in the abdomen etc) when the liver is damaged irreversibly—cirrhosis,” says Dr Raju.

The primary spread of infection is through shared infected needles, improperly sterilised operation equipment, infected blood and blood products used during blood transfusions. It also spreads through through sex, intravenous drug usage of shared infected needles, razors, tattooing, beauty parlour treatments like manicures and pedicures that may leave cuts.

“The solution is for everyone to get tested, especially those at high risk: healthcare professionals who are at risk for needlestick injuries, those who have had operations in the last 25 years (even dental procedures), those who have had blood transfusions (prior to 2002, when testing for it became a legal requirement for blood banks), people who have had a number of sexual partners, and those under the HIV scanner,” warns Dr Raju.