Hepatitis B is a potentially serious form of liver

inflammation due to infection by the Hepatitis B virus

(HBV) and is one of the most common chronic infectious
diseases worldwide. A case of HBV infection in a 50 years
old female enrolled for homeopathic treatment is reported
here. This case shows the usefulness of homeopathic
medicines in giving not only symptomatic relief to the
patient but also improving the pathological findings.
INTRODUCTION

Chronic hepatitis B (CHB) is dened as persistence of

HBsAg in the circulation for more than 6 months1. At the
beginning of the third millennium, Hepatitis B virus (HBV)
remains a major public health problem globally; more than
two billion people have been infected worldwide, and of
these, 350-400 million suffer from chronic infection 2, 3. HBV
infection can induce a wide spectrum of clinical features,
ranging from an inactive carrier state to fulminate hepatitis,
cirrhosis, or hepatocellular carcinoma4.
Most patients with chronic Hepatitis B are clinically
asymptomatic. Some may have nonspecific symptoms such
as fatigue. In most instances, significant clinical symptoms
will develop only if liver disease progresses to
decompensated cirrhosis. In addition, extrahepatic
manifestations may cause symptoms. Accordingly, physical
examination will be normal in most instances. In advanced
liver disease there may be stigmata of chronic liver disease
such as splenomegaly, spider angiomata, Caput medusae,
palmar erythema, testicular atrophy, gynecomastia, etc. In
patients with decompensated cirrhosis, jaundice, ascites,
peripheral edema, and encephalopathy may be present5.
Hepatitis B is diagnosed by detecting one of the viral
antigens called hepatitis B surface antigen (HBsAg) in the
blood. Later in the acute disease, HBsAg may no longer be
present, in which case a test for antibodies to a different
antigen hepatitis B core antigen is used. If HBsAg can be

detected in the blood for longer than six months, chronic

hepatitis B is diagnosed6.
HBV and HDV were transmitted frequently by blood
transfusion. Vertical transmission and sexual exposure have
become the most frequent routes of HBV infection. Medical
procedures still represent a potential source for HBV
transmissions and thus strict and careful application of
standard hygienic precautions for all medical
interventions are absolutely mandatory not only in endemic
areas but also in Western countries. This holds true in
particular for immunocompromised individuals who are
highly susceptible to HBV infection as HBV is characterized
by a very high infectivity7.
An increasing number of patients are treated with methods
of complementary and alternative medicine (CAM) 8.
Homeopathy is one of the most widespread and
controversial therapies of CAM9 offering a natural and
effective alternative to conventional medicine, which is
overly-dependent on the synthetic remedies of
multinational big pharma10. In spite of widespread
acceptance of the merits of CAM within the general public
and amongst many medical practitioners, these more
controversial treatments have faced sustained opposition
from those who advocate an evidence-based approach.
Homeopathy, in particular, has been the target of sustained
criticism11-15.
The homoeopathic approach is like should be cured with
like. Although homeopathy seems scientifically
implausible, three meta-analyses of controlled trials have
found an effect greater than placebo in different diseases16-18.
Numerous early attempts have been made to prove the
efficacy of ultra-highly diluted homeopathic remedies, but
most have not been accepted due to some lacunae in
experimental design or for methodological shortcomings, or
for some other flaws in the reports19-21. However, KhudaBukhsh et al.22-25 proposed a gene-regulatory hypothesis to

explain the possible molecular mechanism of action of

potentized homeopathic drugs with much circumstantial
evidence to support their claim; this also needs to be further
validated.
CASE PRESENTATION

Mrs. S. S. age 50 years, was diagnosed as Hepatitis B +ve in

14 may 2012 by ELISA. On 16 March 2013 she was reinvestigated for the detection of HBV-DNA by PCR, and this
time it detected HBV DNA. On December 24, 2012, she was
consulted for homeopathic treatment of HBV infection.

Presenting Complaints

Pulsating headache of vertex region from the age of puberty, headache

aggravated from cold wind, combing hair and during menses, and improved
by wrapping up head with a cloth. (for 37 years)
Pain epigastric region with sensation of fullness which aggravates after
eating. (5 months ago)
Pain right upper quadrant
Aching pain in chest with difficult breathing (5 month ago)
Abdominal pain aggravated after eating followed by loose stool. (5 months
ago)
Pain cervical region with morning stiffness.
Patient experienced heat flushes in body on and off with heat in palm and
soles, and she must uncover them even in winter. (for 2 years)
Patient was restless and physically weak.
Generally all symptoms worse by late night-watching or loss of sleep.

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SAMPLE CASE STUDY:-

History of presenting illness

Patient was alright 37 years ago when she then experienced

a headache during puberty. Fifteen years ago she developed
a feverish condition and consulted for a medical opinion.
Laboratory tests were performed and HBs Ag test was
positive. She had climacteric for 2 years. Five months ago
she developed chest pain with difficult breathing,
abdominal pain with loose stools and was admitted to a

hospital. She was diagnosed with Active HBV with an ALT

about 57 u/l.
Past History

Personal History

H/o Malaria fever

Family History

H/o Hepatitis B, Uterine Fibroid and Heart disease in Mother

H/o Heart attack in grandfather/Maternal side.

PHYSICAL GENERALS

Appetite

: Diminished

Thirst

: Excessive for cold water

Desires
cream

: Spicy food, sweets, cold drinks and foods, ice

Bowel Habits

: Urging for stool eating after

Urination : Frequent Urging

Perspiration
Sleep

: Profuse

: Un-refreshing

Thermal reaction : Hot patient

PHYSICAL EXAMINATION

Red discoloration of palms and nose

Goiter
Hypertension 170/100
Tachycardia

LABORATORY INVESTIGATIONS

HBs Ag by ELISA Method

HBV DNA by PCR
ALT

LABORATORY REPORTS AT ENTRY

HBs Ag by ELISA Method : Reactive

HBV DNA by PCR : Detected

ALT : 57 u/l

ANALYSIS AND EVALUATION OF SYMPTOMS

MENTALS:
Irritability

Anger at trifles
PARTICULARS:
PULSATING, throbbing Headache of Vertex
HEADACHE ameliorates by wrapping up head
HEADACHE from cold air
FULLNESS, sensation of stomach, aggravation eating after
PAIN stomach, eating agg