According to WHO, approximately 325 million people worldwide are living with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. As per their latest assessment, in India, around 40 million people are chronically infected with HBV and 6 to 12 million are suffering from HCV.
The ‘WHO Global hepatitis report, 2017’ indicates that a large majority of these people lack access to life-saving testing and treatment. As a result, millions face risk of chronic liver disease, cancer, and death. What the general public is not aware of is that HBV is also one of the reasons behind infertility in males.
Hepatitis B virus’ ’S’ protein is known to lower sperm motility and reduce the fertilisation rate by more than half. Studies indicate that those with HBV are 1.59 times more likely to experience infertility than individuals who are not infected.
According to Dr Hrishikesh D Pai, director IVF & Infertility, Fortis La Femme Hospital, Delhi and secretary general of the Federation of Obstetrics and Gynecological Societies of India, “Hepatitis does not have any effect on the normal functioning of the ovarian or uterine glands. However, this virus impacts spermatogenesis negatively in males. This causes a reduction in the sperm count, free testosterone levels, motility, viability, and morphology which further impacts overall fertility and ability to produce an offspring in them. On World Hepatitis Day, the need of the hour is to offer testing for HBsAg and HCV in infertile couples. This would help them get some clarity on the fertility therapy they should choose and reduce any potential risk of transmission to an uninfected partner or baby.”
Under such circumstances, it is important to counsel couples who have been tested positive for hepatitis and are seeking fertility treatments. This would in turn enable them to understand the transmission risk of the disease.
“Transmission risk from mother to baby increases by 80-90 per cent in HBV cases and 11 per cent in HCV positive cases, where there is high viral load. Some ways to reduce this risk include semen washing, administering the uninfected partner with HBV vaccination, and treatment with Interferon and Ribavirin. Many couples would have doubts, fears, and misconceptions in their mind about this condition,” says Dr Nandita Palshetkar, director, IVF and Infertility, Fortis Bloom IVF Center, La Femme and Fortis Hospital Gurgaon.
On World Hepatitis Day, it is important to encourage couples to come out and talk about these fears and apprehensions through support and peer groups as in the West.
People affected by Hepatitis
According to WHO, viral hepatitis has been responsible for an estimated 1.4 million deaths. The ‘Global Health Sector Strategy on Viral Hepatitis report (2016-2021)’ stated that out of the 1.4 million deaths, approximately 48 per cent of the patients suffer from hepatitis C virus, 47 per cent from hepatitis B virus, and the remaining from hepatitis A and hepatitis E viruses.
Commenting on the same, Dr B R Das, mentor, Molecular Pathology, SRL Diagnostics says, “Hepatitis has largely been ignored as a health and development priority. With time, there has been huge influx of people into urban areas of India and significant changes in lifestyle of the urban population. For HEV and HAV infections hygiene and sanitation practices play major roles, while for HBV and HCV, lifestyle and awareness are very important.”