Multiple strategies are needed to eliminate viral hepatitis

  • Effective screening and prompt referral can help in identifying people suffering from Hepatitis and timely treatment
  • Vaccination and awareness through public education can support in eliminating Hepatitis

World Hepatitis Day is observed each year on 28 July to enhance awareness of viral hepatitis, an inflammation of the liver that causes a range of health problems, including liver cancer. This year’s theme is “to find the missing millions”.

There are 5 main types of hepatitis viruses - A, B, C, D and E. These 5 types are of greatest concern because of the burden of illness, potential for outbreaks, epidemic spread and death caused by them. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.

Viral hepatitis B and C affect 32.5 Cr people worldwide. It is one of the leading causes of death globally, accounting for 13.4 Lakh deaths per year – that’s more than HIV/AIDS, tuberculosis or malaria.

What is concerning is the fact that 80% of the Hepatitis B & C patients around the world do not know that they are suffering from the disease. Only way to know this is by getting tested. World Hepatitis Alliance and World Health Organization have taken up the objective of eliminating Hepatitis B & C by 2030 and finding the ‘missing millions’ who are suffering from hepatitis and are not aware of it. World over, governments, organizations, health authorities and not for profits are working together on strategies to achieve this objective.

According to WHO 1 in 3 people in the world are either infected from Hepatitis B or Hepatitis C. In fact, 90% of hepatitis related deaths happen due to Hepatitis B & C and whilst remaining 10% by all other hepatitis viruses. Every year 780000 Hepatitis B virus related deaths and 399000 Hepatitis C related deaths are document around the world.

In India, 3% of non-tribal and 11.85% of tribal Indian population suffers from Hepatitis B and close to 1-1.9% Indians suffer from Hepatitis C infections.

About Hepatitis B & Hepatitis C

Although it is possible to acquire Hepatitis B through contact with infected blood or blood products. Hepatitis B transmission often occurs through other bodily fluids. The transmission may also occur through sex, and a woman can pass the infection to her baby during delivery or childbirth. Good news is, the hepatitis B virus gets cleared in approximately 80% of infected people within 6 months of contracting infection. Sadly, in 20% patients it gets developed as chronic Hepatitis B. In some of these patients, the hepatitis B virus can also cause a chronic liver infection that can later develop into cirrhosis (a scarring of the liver) or liver cancer.

Hepatitis C can also cause acute infections. They infections occur due to exposure to infected blood, which can happen by sharing needles, poor infection control, or during childbirth. People who have undergone blood transfusion or organ transplant before 1992 could have gotten infected during this procedure, as prior to 1992 the blood was not screened for hepatitis C infections before blood transfusion.

Because Hepatitis C infections usually do not show any symptoms, very few people are diagnosed when the infection is recent. In people who are diagnosed with chronic liver disease due to Hepatitis C, symptoms usually surface decades after contracting the infection.

Way forward

Along with proactive screening of Hepatitis B & C, especially in the high-risk groups; there is a need to implement prevention and control approaches for viral hepatitis such as, raising awareness through public education, vaccination, blood transfusion safety strategies and effective medical support.

With Screening, prevention and control strategies along with effective vaccines and treatment for Hepatitis B and a cure for Hepatitis C, the global commitment of eliminating viral hepatitis by 2030 is achievable. As on date 42% children globally, have access to preventive Hepatitis B vaccine.

Even in India various medical, social and corporate bodies are working together to find the country’s ‘missing millions,’i.e. people living with undiagnosed hepatitis. So let’s propagate this message of getting each of us tested for hepatitis and get those who come positive with the test to get them the required treatment. Hepatitis B vaccination is also a part of Universal Immunization plan and efforts are being made to ensure that all children get it.

In the state

To support the state of Assam in finding it’s ‘missing millions,’ Dr. B D Goswami, Gastroenterologist and Hepatologist, Dispur Hospital, Guwahati and Tata Trusts have initiated a screening and prompt referral programme. Hepatitis B and C screening, awareness and prompt referral of detected patients are being conducted. Special camps are being held for high-risk population.

Conclusion

As on date, we do not have a single measure strong enough to curb viral hepatitis epidemic, but having a global vision and implementing multiple strategies at national and state level will go a long way towards reducing the disease burden. So screening-test-contact tracing-treat is the way forward to mitigate this global infectious disease.

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