People in the world are marking World Hepatitis Day. World Health Organization has called on governments and other health agents to ensure that people “know” and “act” on hepatitis.
Globally, viral hepatitis infection affects 400 million people– over 10 times the number of people affected by HIV. Even with these numbers, just one in 20 people with viral hepatitis know they are infected, and only one in 100 with the disease is being treated.
Yet, hepatitis is fully preventable and treatable: there are effective vaccines and treatments for hepatitis B, and over 90 percent of people with hepatitis C can be cured with treatment.
Hepatitis refers to the inflammation of the liver as a result of infection or exposure to harmful or toxic substances such as drugs or alcohol. Although some types of hepatitis will pass without leading to permanent damage to the liver, chronic cases can cause cirrhosis, cancer or liver failure.
Despite the fact that most of the people in the world are not aware of the disease, the international public health agency has envisioned the elimination of the public health threat by 2030, if people and countries affected by this disease were better equipped and enabled to “know hepatitis” and “act now”.
“The world has ignored hepatitis at its peril,” said Dr Margaret Chan, WHO Director-General. “It is time to mobilize a global response to hepatitis on the scale similar to that generated to fight other communicable diseases like HIV/AIDS and tuberculosis.”
In 2013, an estimated 1.45 million people died of the disease- up from less than a million in 1990. But with a better understanding of prevention, thousands of lives could be saved every year.
In a bid to meet the set targets, World Health Assembly met in May 2016 where 194 governments adopted the first-ever Global Health Sector Strategy on viral hepatitis and agreed to the first-ever global targets. The organization hopes that through the strategy, about 8 million people with hepatitis B or C will be treated by 2020. The longer term aim is to reduce new viral hepatitis infections by 90 percent and to reduce the number of deaths due to viral hepatitis by 65% by 2030 from 2016 figures.
“We need to act now to stop people from dying needlessly from hepatitis,” said Dr Gottfried Hirnschall, WHO's Director of the HIV/AIDS Department and Global Hepatitis Programme. “This requires a rapid acceleration of access to services and medicines for all people in need.”
WHO acknowledges that although the strategy is ambitious, the tools to achieve the targets are already in place. While the vaccine for hepatitis C is not available, there has been dramatic progress in treatment for the disease in the past few years. On the other hand, there is an effective vaccine and treatment for hepatitis B. Additionally, the availability of oral medicines, called direct-acting antivirals, has made it possible to potentially cure more than 90 percent of patients within 2–3 months. But in many countries, current policies, regulations and medicine prices put the cure out of most people’s reach.
There are five main hepatitis viruses: A, B, C, D, and E.
Hepatitis A (HAV) is normally transmitted through consumption of contaminated water or food. The virus can also be spread through sex or via injecting drugs. Mostly, the majority of HAV infections are mild and the patient is able to recover fully.
In most cases, the hepatitis B virus (HBV) can be transmitted through exposure to infected blood, semen, and other body fluids. It has been found that the virus can be passed from infected mothers to infants during birth. The virus can also be transmitted via contaminated blood transfusions, unsafe medical procedures, and by injection drug use.
Although hepatitis C, or HCV, is commonly transmitted through exposure to infected blood by injection drug use, transmission by unprotected sex is also possible, though in rare cases. Currently, there is no injection for this virus but research into development is ongoing.
Hepatitis D (HDV) infections occur only among people already infected with hepatitis B. Enduring hepatitis D can increase the risk of developing cirrhosis of the liver.
The hepatitis E virus, which is common in developing countries, is mostly transmitted through consumption of contaminated water or food. It is largely spread by drinking water contaminated with the feces of someone infected with hepatitis E. While the infection normally clears within 2 to 6 weeks, it can occasionally lead to acute liver failure.
To prevent the spread of hepatitis (B and C), blood safety strategies should be implemented, with a quality-assured screening of all donated blood and blood components used for transfusion. Safe injection practices should also be implemented as well as rehabilitation of drug addicts who use injections. It is also advisable that people maintain safer sex practices, including minimizing the number of partners and use of protective measures such as condoms.
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