“Invest in eliminating hepatitis” : World Hepatitis Day

World Hepatitis Day (WHD): 28th July is observed as WHD to raise the awareness of the global burden of Viral Hepatitis and to influence real change. The date of 28th July was chosen because it is the birthday of Nobel prize-winning scientist Dr. Baruch Blumberg, who discovered the Hepatitis B virus (HBV) and developed a diagnostic test and vaccine for the virus.

The theme for this year is “Invest in eliminating hepatitis” and the campaign for 2019 focuses on “Finding the Missing Millions”, three-year global awareness-raising and advocacy campaign aimed at tackling the main barriers to diagnosis.

Five viral agents are mainly associated with viral hepatitis. These viruses are denominated Hepatitis A, B, C, D, and E viruses in order of their discovery. They all cause hepatitis, which can range in clinical severity from asymptomatic illness to fulminant hepatitis (acute liver failure). Viral hepatitis B and C affect 325 million people worldwide causing 1.4 million deaths a year. It is the second major killer infectious disease after tuberculosis, and 9 times more people are infected with hepatitis than HIV. Deaths from hepatitis are increasing over the past 2 decades. Chronic infections of Hepatitis B and C may not show symptoms for a long period, sometimes years and decades, slowly and silently damaging the liver, eventually causing cancer. Over 60% of liver cancer cases are due to late testing and treatment of viral Hepatitis B and C.

Hepatitis is preventable, treatable, and in the case of hepatitis C, curable. The Hepatitis B vaccine is 98-100% effective in preventing new infections. For Hepatitis B, people should be tested and if found positive and eligible, provided with lifelong treatment. For Hepatitis C, people can be cured with simple 2-3 months treatment with Direct-Acting Antiviral (DAA) drug. However, over 80% of people living with hepatitis are lacking prevention, testing, and treatment services.

Among people living with Hepatitis B and C, only 10% and 15% knew their infection status respectively and only very few among them received the treatment. Screening among the community and Hepatitis B vaccination efforts are urgently needed.

If an individual is diagnosed with hepatitis B or C, he/she must speak with health workers about potential treatment, monitoring or curative therapy. If detected early, the risk of chronic illnesses and financial burden for the family can be averted. Take action today.

STRATEGIES FOR POLICYMAKERS

1. Viral hepatitis B and C is a leading infectious killer, yet the majority of global leaders and the public remain unaware.

2. Despite this situation, much can be done: hepatitis can be prevented, diagnosed, treated and managed well.

3. However, most of the people living with hepatitis – over 80% – lack access to testing or treatment.

4. At the same time, people are becoming newly infected due to lack of prevention services.

5. Achieving hepatitis elimination by 2030 will require a major increase in funding for hepatitis prevention, testing and treatment services as part of achieving universal health coverage (UHC).

6. Countries need to ensure that national hepatitis testing and treatment plans include dedicated funding and investments.

7. Countries should seek the most optimal prices for medicines and diagnostics.

8. Investing in hepatitis is a smart decision for broader health outcome.

9. Investing in hepatitis testing and treatment means preventing liver cancer.

10. On World Hepatitis Day 2019, join the cause to help 325 million people.

FOR THE PUBLIC:

Know. Prevent. Test. Eliminate Hepatitis.

1. Get tested: Early testing means early treatment to prevent illness and to save your life.

2. Hepatitis B and C are preventable: Every injection should be safe. Hepatitis B vaccine provides lifelong protection. They can be transmitted by sex, therefore protect yourself by using condoms.

3. If tested positive: Ask whether you need treatment-do not delay.

4. Hepatitis B: Some people need treatment and can stay healthy with life-long therapy.

5.Hepatitis C: 3-month treatment can cure the infection.

6. If infected with Hepatitis contact Department of Gastroenterology & Liver at KLES Dr. Prabhakar kore Hospital, Belagavi. For comprehensive counseling, care and treatment options.

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FREE CAMPS

The Department of Gastroenterology of KLES Dr. Prabhakar Kore Hospital has been doing free camps to spread awareness about different hepatitis viruses, screening patients for infection, putting them on treatment and vaccination camps at different places.

Till date, more than 30,000 population have been screened for hepatitis B and C viruses. Those found negative have been given hepatitis B vaccination and those found positive have been treated at subsidized charges.

KLES Hospital will be conducting camps for Hepatitis B and C from 9 am to 1 pm on every second Saturday of the month at KLES Yallur Hospital, every second Sunday at Kerudi Hospital in Bagalkot, every third Saturday at KLES ICU, Chikkodi and every fourth Saturday at KLES Prabhakar Kore Hospital, Belagavi, according to a release.

HEPATITIS A

Hepatitis A is a viral liver disease that can cause mild to severe illness.

The Hepatitis A virus is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person.

Almost everyone recovers fully from hepatitis A with lifelong immunity. However, a very small proportion of people infected with Hepatitis A could die from fulminant hepatitis.

WHO estimates that hepatitis A caused approximately 7134 deaths in 2016.

The risk of hepatitis A infection is associated with a lack of safe water, and poor sanitation and hygiene.

In countries where the risk of infection from food and water is low, there are outbreaks among men who have sex with men (MSM) and persons who inject drugs (PWIDs).

Epidemics can be prolonged and cause substantial economic loss.

A safe and effective vaccine is available to prevent hepatitis A.

Safe water supply, food safety, improved sanitation, hand washing, and the hepatitis A vaccine are the most effective ways to combat the disease. Persons at high risk, such as travelers to countries with high levels of infection, MSM and PWIDs can get vaccinated

HEPATITIS B

Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease.

The virus is most commonly transmitted from mother to child during birth and delivery, as well as through contact with blood or other body fluids.

WHO estimates that in 2015, 257 million people were living with chronic hepatitis B infection (defined as hepatitis B surface antigen-positive).

In 2015, hepatitis B resulted in an estimated 887000 deaths, mostly from cirrhosis and hepatocellular carcinoma.

As of 2016, 27 million people (10.5% of all people estimated to be living with hepatitis B) were aware of their infection, while 4.5 million (16.7%) of the people diagnosed were on treatment.

Hepatitis B can be prevented by vaccines that are safe, available and effective.

HEPATITIS C

Hepatitis C is a liver disease caused by the hepatitis C virus. The virus can cause both acute and chronic hepatitis, ranging from a mild illness lasting a few weeks to serious, lifelong illness.

Hepatitis C is a major cause of liver cancer.

The hepatitis C virus is a bloodborne virus. The most common modes of infection are through exposure to small quantities of blood. This may happen through injection drug use, unsafe injection practices, unsafe health care, transfusion of unscreened blood and blood products, and sexual practices that lead to exposure to blood.

Globally, an estimated 71 million people have chronic hepatitis C virus infection.

A significant number of those who are chronically infected will develop cirrhosis or liver cancer.

WHO estimated that in 2016, approximately 399000 people died from hepatitis C, mostly from cirrhosis and hepatocellular carcinoma.

Antiviral medicine can cure more than 95% of persons with hepatitis C infection, thereby reducing the risk of death from cirrhosis and liver cancer, but access to diagnosis and treatment is low.

There is currently no effective vaccine against hepatitis C; however, research in this area are ongoing.

HEPATITIS D

Hepatitis D virus is a virus that requires hepatitis B virus for its replication. HDV infection occurs only simultaneously or as super-infection with HBV.

The virus is most commonly transmitted from mother to child during birth and delivery, as well as through contact with blood or other body fluids.

Vertical transmission from mother to child is rare.

At least 5% of people with chronic HBV infection are co-infected with HDV worldwide. However, this is a broad global estimation since many countries do not report the prevalence of HDV.

Worldwide, the overall number of HDV infection has decreased since the 1980s. This trend is due to successful global HBV vaccination program.

HDV-HBV co-infection is considered the most severe form of chronic viral hepatitis due to more rapid progression towards liver-related death and hepatocellular carcinoma.

Currently, treatment success rates are generally low.

Hepatitis D infection can be prevented by hepatitis B immunization.

HEPATITIS E

Hepatitis E is a liver disease caused by infection with a virus known as the hepatitis E virus (HEV).

Every year, there are an estimated 20 million HEV infections worldwide, leading to an estimated 3.3 million symptomatic cases of hepatitis E.

WHO estimates that hepatitis E caused approximately 44000 deaths in 2015.

The virus is transmitted via the fecal-oral route, principally via contaminated water.

Hepatitis E is found worldwide, but the disease is most common in East and South Asia.

A vaccine to prevent hepatitis E virus infection has been developed and is licensed in China, but is not yet available elsewhere.

dr-hazare
About the Author: Dr. Santosh Hajare, MD, DM, DNB (Gastro),
Department of Gastroenterology & Liver KLES Dr. Prabhakar Kore Hosptial & MRC Belagavi. Contact: 94481 11913

Any query regarding Hepatitis virus can be sent to myarogya.in@gmail.com

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