World Hepatitis Day
It can be acute (inflammation of the liver that presents with sickness — jaundice, fever, vomiting) or chronic (inflammation of the liver that lasts more than six months, but essentially showing no symptoms).
Hepatitis Day 28 July as Important Day
Usually caused by a group of viruses known as the “hepatotropic” (liver directed) viruses, including A, B, C, D and E.
Other viruses may also cause it, such as the varicella virus that causes chicken pox.
SARS-CoV-2, the virus causing Covid-19 may injure the liver too.
Other causes include drugs and alcohol abuse, fat buildup in the liver (fatty liver hepatitis) or an autoimmune process in which a person’s body makes antibodies that attack the liver (autoimmune hepatitis).
Hepatitis is the only communicable disease where mortality is showing an increasing trend.
Treatment
Hepatitis A and E are self-limiting diseases (i.e. go away on their own) and require no specific antiviral medications.
For Hepatitis B and C, effective medications are available.
Global Scenario
Approximately 354 million people are suffering from hepatitis B and C.
Southeast Asia has 20% of the global morbidity burden of hepatitis.
About 95% of all hepatitis-related deaths are due to cirrhosis and liver cancers caused by the hepatitis B and C virus.
Indian Scenario
Viral hepatitis, caused by hepatitis viruses A through E, still remains a major public health problem in India
India has “intermediate to high endemicity” for Hepatitis B surface antigen and an estimated 40 million chronic HBV infected people, constituting approximately 11% of the estimated global burden.
Population prevalence of chronic HBV infection in India is around 3-4 %.
Challenges
Access to healthcare services is often out of reach for communities as they are usually available at centralised/specialised hospitals at a cost which cannot be afforded by all.
People continue to die because of late diagnosis or lack of appropriate treatment. Early diagnosis is the gateway for both prevention and successful treatment.
In the Southeast Asia region, only about 10% of people with hepatitis know their status; and of them, only 5% are on treatment.
Of the estimated 10.5 million people with hepatitis C, just 7% know their status, of which around one in five are on treatment.
What is the Global Target For Hepatitis
The Global Target is to eliminate viral hepatitis as a public health threat by 2030.
How to achieve the Target
By 2025, we must reduce new infections of hepatitis B and C by 50%, reduce deaths from liver cancer by 40%, ensure that 60% of people living with hepatitis B and C are diagnosed and that half of those eligible receive appropriate treatment.
There is a need to enhance political commitment across all countries of the region and:
Ensure sustained domestic funding for hepatitis.
Improve access to drugs and diagnostics by further reducing prices.
Develop communication strategies to increase awareness.
Innovate service delivery to maximise the use of differentiated and people-centred service delivery options across HIV and deliver services according to people’s needs and preferences in line with the primary healthcare approach.
Decentralising hepatitis care to peripheral health facilities, community-based venues and locations beyond hospital sites brings care nearer to patients’ homes.
An integrated Regional Action Plan for viral hepatitis, HIV and Sexually Transmitted Infection STIs 2022–2026 is being developed by WHO.
This will ensure effective and efficient utilisation of limited resources available for the region and will guide countries to adopt a person-centred approach rather than a disease-specific one.
Way Forward
Clean food and good personal hygiene, along with access to safe water and sanitation, can protect us from hepatitis A and E.
Measures to prevent hepatitis B and C need to focus on full coverage with hepatitis B immunisation including a birth dose, as well as access to safe blood, safe sex and safe needle usage.
Safe and effective vaccines exist to prevent hepatitis B, alongside new and powerful antiviral drugs that can manage chronic hepatitis B and cure most cases of hepatitis C.
These interventions together with early diagnosis and awareness campaigns have the potential to prevent 4.5 million premature deaths in low- and middle-income countries by 2030 globally.
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