World Hepatitis Day

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    • World Hepatitis Day is celebrated on July 29th, every year.

    About

    • On this Day, the World Health Organisation (WHO) is highlighting the need to bring hepatitis care closer to the people in need. 
    • 2022 Theme:  “Bringing hepatitis care closer to you
    • 3 As: This means making hepatitis care available, affordable and accessible to all without discrimination. 
    • This is crucial in the quest to eliminate viral hepatitis as a public health threat by 2030, a global target. 
      • WHO’s global hepatitis strategy, endorsed by all WHO member States, aims to reduce new hepatitis infections by 90% and deaths by 65% between 2016 and 2030.

    Need for Action

    • Hepatitis is the only communicable disease where mortality is showing an increasing trend
    • Globally, approximately 354 million people are suffering from hepatitis B and C. 
    • Southeast Asia has 20% of the global morbidity burden of hepatitis. About 95% of all hepatitis-related deaths are due to cirrhosis and liver cancers caused by the hepatitis B and C virus.
    • A world free of hepatitis is practical and feasible. The tools to diagnose, treat, and prevent are present. 
    • Indian Scenario: Viral hepatitis, caused by hepatitis viruses A through E, still remains a major public health problem in India
      • India has “intermediate to high endemicity” for Hepatitis B surface antigen and an estimated 40 million chronic HBV infected people, constituting approximately 11% of the estimated global burden.

    Hepatitis 

    • Hepatitis means inflammation of the liver
    • Problem causing agents: Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis. However, hepatitis is often caused by a virus. 
    • Main Strains: 
      • There are five main strains of the hepatitis virus, referred to as types A, B, C, D and E. 
      • While they all cause liver disease, they differ in important ways including modes of transmission, severity of the illness, geographical distribution and prevention methods.
      • 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, liver cancer and viral hepatitis-related deaths.
    • Common symptoms of infectious hepatitis include:
      • Fatigue
      • Flu-Like Symptoms
      • Dark Urine
      • Pale Stool
      • Abdominal Pain
      • Loss Of Appetite
      • Unexplained Weight Loss
      • Yellow Skin And Eyes, Which May Be Signs Of Jaundice
    • Treatment: 
      • Hepatitis A: Hepatitis A is a short-term illness and may not require treatment. 
      • Hepatitis B: There is no specific treatment program for acute hepatitis B. 
      • Hepatitis C: Antiviral medications can treat both acute and chronic forms of hepatitis C.
      • Hepatitis D: The WHO trusted Source lists pegylated interferon alpha as a treatment for hepatitis D. However, this medication can have severe side effects. 
      • Hepatitis E: Currently, no specific medical therapies are available to treat hepatitis E. However, pregnant women who develop this infection require close monitoring and care.
      • Autoimmune hepatitis: Corticosteroids, like prednisone or budesonide, are extremely important in the early treatment of autoimmune hepatitis. They’re effective in about 80 per cent of people with this condition.

    Issues

    • Access to these services is often out of reach for communities as they are usually available at centralised/specialised hospitals at a cost which cannot be afforded by all. 
    • People continue to die because of late diagnosis or lack of appropriate treatment. Delay in treatment for Hepatitis B and C may lead to liver cancers.
    • Modest testing and treatment coverage is the most important gap to be addressed. 
    • Cascading effect of treatment in South East Asia: 
      • Only about 10% of people with hepatitis know their status; and of them, only 5% are on treatment. 
      • Of the estimated 10.5 million people with hepatitis C, just 7% know their status, of which around one in five are on treatment. This gap needs to be patched up. This is what this year’s World Hepatitis Day campaign is all about.

    How to achieve the elimination Target?

    • The Global Target is to eliminate viral hepatitis as a public health threat by 2030.
    • By 2025, we must reduce new infections of hepatitis B and C by half, reduce deaths from liver cancer by 40%, ensure that 60% of people living with hepatitis B and C are diagnosed and that half of those eligible receive appropriate treatment. This can only be achieved if hepatitis care reaches the community. 
    • Several priorities must be addressed for this. These include:
      • The need to enhance political commitment across all countries of the region and ensure sustained domestic funding for hepatitis; 
      • Improve access to drugs and diagnostics by further reducing prices; 
      • Develop communication strategies to increase awareness; and 
      • Innovate service delivery to maximise the use of differentiated and 
      • People-centred service delivery options across HIV, viral hepatitis and STIs to tailor and deliver services according to people’s needs and preferences in line with the primary healthcare approach. 
      • Decentralising hepatitis care to peripheral health facilities, community-based venues and locations beyond hospital sites brings care nearer to patients’ homes.
    • An integrated Regional Action Plan for viral hepatitis, HIV and STIs 2022–2026 is being developed by WHO.  

    India’s Initiatives

    • Hepatitis B is included under India’s Universal Immunization Programme (UIP) which provides free of cost vaccination against eleven (excluding Hepatitis B) vaccine-preventable diseases i.e. Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Pneumonia and Meningitis due to Haemophilus Influenzae type b (Hib), Measles, Rubella, Japanese Encephalitis (JE) and Rotavirus diarrhoea.
    • Recently, an automated coronavirus testing device named ‘COBAS 6800’ was launched which can also detect viral Hepatitis B & C, among others.

    Way Ahead

    • Clean food and good personal hygiene, along with access to safe water and sanitation, can protect us from hepatitis A and E
    • Measures to prevent hepatitis B and C need to focus on full coverage with hepatitis B immunisation including a birth dose, as well as access to safe blood, safe sex and safe needle usage.
    • Safe and effective vaccines exist to prevent hepatitis B, alongside new and powerful antiviral drugs that can manage chronic hepatitis B and cure most cases of hepatitis C. 
    • These interventions together with early diagnosis and awareness campaigns have the potential to prevent 4.5 million premature deaths in low- and middle-income countries by 2030 globally.

    Source: TH