Elimination of Viral Hepatitis CAN’T WAIT.

Affecting more than 350 million people, and causing more than a million deaths each year, Viral hepatitis is the leading cause of chronic liver disease, cirrhosis and hepatocellular carcinoma (HCC), worldwide.

While mortality due to other leading causes like Tuberculosis and HIV are going down globally, deaths due to viral hepatitis are on the rise. Drug abuse, insufficient vaccination, poor hygienic conditions, inadequate epidemiological data and lack of proper testing services are thought to be main contributors of this global burden.

The World Health Organization (WHO) is setting global goal to ‘eliminate vial hepatitis as a threat’ by 2030. The WHO translates this objective as a reduction in incidence of viral hepatitis cases by 90% (95% for HBV and 85% for HCV) and mortality rates by 65%, by the year 2030, compared to the baseline (at 2015).

Hepatitis B and Hepatitis C account for nearly 96% of mortality due to Viral hepatitis.

Testing remains the key for treating and eradicating Viral Hepatitis, as 9 out of 10 people living with viral hepatitis are not aware of their status, globally.

The World Hepatitis Day 2020 pledged for a ‘Hepatitis free future’ and the campaign to ‘find the missing millions’ (of those infected with viral hepatitis) launched in 2018 is in its 3rd and final year now.

Hepatitis B is the major contributor to viral hepatitis cases across the world, and the most common route of transmission is perinatal (from mother to child). For this reason, the WHO is urging all nations to vaccinate infants against Hepatitis B at birth, followed by 2 more doses at the end of 1 and 6 months respectively.

The strategy for prevention and elimination of Viral Hepatitis as a threat includes:

  • Vaccinate – For Hepatitis A and B.
  • Stop mother to child transmission – Pregnant women should be tested for viral hepatitis. The risk of vertical transmission (mother to child) is highest with Hepatitis B, and if a pregnant woman is found to be Hepatitis B positive, she should be referred to experienced doctors.
  • Pregnant Hepatitis B women should be treated, where required.
  • Infants born to Hepatitis B positive mothers have the highest chance to be prevented from acquiring the virus, if vaccinated within the first 12-24 hours of birth.
  • Maximize testing – Every individual should have access to testing. As chronic hepatitis B and C are mostly asymptomatic in the initial stages and take up to 15-20 years to cause significant liver damage and cause symptoms, testing remains the only way to detect viral hepatitis at an early stage.
  • People who inject drugs, prison inmates, migrants and those living in endemic areas and other high-risk populations (frequent travelers, homosexuals, homeless, diabetics, and people with HIV/AIDS) should be regularly tested.
  • Treat – As highly effective treatments are now available for Hepatitis B and C, initiating people who tested positive for these viruses on treatment without delay, forms the main stay of prevention, reduction of mortality and transmission rates.
  • Blood and surgical safety – Strict precautions should be adopted during transfusions, surgeries and other procedures involving exposure to blood and blood products.
  • Increase Access – Increase access to all individuals for diagnosis, prevention, treatment and care services for Viral hepatitis. It is estimated that nearly 80% of people living with viral hepatitis do not have access to the services they need.
  • Integration of services – Integrate elimination of viral hepatitis with other strategic health services at the state/ country level.
  • Real world Statistics – Countries should come forward and decide to spend, with or without partnership from other health organizations, to establish the rates of incidence and prevalence and geographical regions causing the most burden and that carry the highest risk.

The scale of the task to prevent and eliminate Viral hepatitis as a global threat is huge warrants a highly coordinated effort from several services and entities such as nations, health authorities (local and global), NGOs, social media and pharmaceutical companies.

Come, let us join hands to recognize and eliminate this global threat

 References:

https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hepatitis/overview

https://www.worldhepatitisday.org/

https://www.worldhepatitisalliance.org/