Eliminate Hepatitis


Viral hepatitis is one of the most important causes of liver disease throughout the world. The World Health Organization (WHO) estimates that about 320 million people worldwide have chronic hepatitis B or C infection.[1]

Hepatitis B and C are the most important cause of liver cancer in the world. They can cause acute (short-term) and chronic (long-term) infection. Middle East, central Asia, Egypt, Pakistan, Certain area of Africa and South East Asia are areas with high prevalence of the condition. It is estimated that more than 90% of infected individuals do not have any symptoms of the disease and hence appear absolutely healthy. Infection with these viruses can occur in people across all age groups. Once infected, the virus continues to damage the liver silently over a period of 20 to 30 years after which the patient may develop advanced liver disease like liver cirrhosis following which liver failure or liver cancer can develop. In its early stages, the condition can be treated with potent anti-viral drugs, however, people often disregard getting treated for this condition because of their lack of awareness.

Hepatitis viruses are of four types – A, B, C, D and E. They can be caused due to different reasons and affect different populations differently.

Hepatitis B is often spread during birth from an infected mother to her baby. Infection can also occur through contact with blood and other body fluids through injection, drug use, unsterile medical equipment, and sexual contact. People who are infected at birth or during early childhood are more likely to develop a chronic infection, which can later lead to liver cirrhosis or liver cancer. The vaccine for hepatitis B is the most effective way to prevent this infection. In the UAE, under the National Immunization Program, all children are being administered a course of four vaccines at birth and during the first year of life. Effective medicines are available for treatment of hepatitis B. Most drugs suppress the multiplication of the virus and need to be taken for several years. These drugs have minimal side effects and are rather effective in preventing progression of liver disease.

Hepatitis C is spread through contact with the blood of an infected person. Infection can occur through injection drug use, unsafe medical injections and other medical procedures. Mother-to-child transmission of hepatitis C is also possible. This can cause both acute and chronic infections, although most infected people develop a chronic infection. A significant number of those who are chronically infected will develop liver cirrhosis or liver cancer. With new oral drugs, over 90% of people with hepatitis C can be cured within 3 months, reducing the risk of death from liver cancer and cirrhosis. The first step for people living with hepatitis C to benefit from treatments is to get tested and treated. There is currently no vaccine available for hepatitis C.

Hepatitis A is primarily spread through contaminated food or drinks or through close personal contact with someone who is infected. Hepatitis A does not cause chronic liver disease and is rarely fatal, but it can cause serious symptoms like jaundice. Hepatitis A can be prevented through improved sanitation, food safety, and vaccination.

Hepatitis E is spread mainly through contaminated drinking water. Hepatitis E is usually cured within 4-6 weeks without any specific treatment. However, pregnant women infected with hepatitis E can develop liver failure are at considerable risk of death from this infection.  Improved sanitation and food safety can help prevent new cases of hepatitis E. Vaccine for Hepatitis E has been developed but is available only in few countries.

Hepatitis D is an uncommon infection occurring in people who are already infected with the hepatitis B virus. It is found only in certain parts of the world like Central Asia. Hepatitis B vaccination also prevents infection with hepatitis D.

World Hepatitis Day is celebrated annually on the 28th July. This day is designated to educate and create awareness about viral hepatitis as a global public health problem, and to stimulate the strengthening of preventive and control measures of this disease. Each year, the WHO and the World Hepatitis Alliance focus on a theme and this year’s theme is “Eliminate Hepatitis”.[2] This day focuses on raising awareness about viral hepatitis, modes of transmission and treatment modalities. The aim is to make people aware about the seriousness of the condition and promote early detection and treatment. On 26th July 2016, the World Hepatitis Alliance launched NOhep, a global movement to eliminate viral hepatitis; providing people a platform to come together and take action to ensure global commitments are met and viral hepatitis is eliminated by 2030, in line with WHO’s vision. The message on World Hepatitis Day is ‘Know the risks, Get tested, Get vaccinated, Get treated’.

Dr. Kaiser Raja

Chief Hepatologist 

Aster Integrated Liver Care Program 

Aster Hospital Mankhool 

References:

[1] http://www.who.int/mediacentre/news/releases/2017/global-hepatitis-report/en/

[2] http://www.mertonccg.nhs.uk/News-Publications/News/Pages/World-Hepatitis-Day—Eliminate-Hepatitis.aspx

 

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