World Hepatitis Day (WHD) takes place every year on 28 July bringing the world together under a single theme to raise awareness of the global burden of viral hepatitis and to influence real change.
Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. There are five main hepatitis viruses, referred to as types A, B, C, D and E. These five types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread.
Hepatitis B and C cause 1.4 million deaths per year – more than HIV/AIDS and malaria, and a number comparable to tuberculosis. Together, these viruses cause two in every three liver cancer deaths across the world.
In India, about 4 crore people are chronically infected with hepatitis B and 60 lakh to 1.2 crore people are chronically infected with hepatitis C. According to the Indian Journal of Medical Research, in India about 2,50,000 people die of viral hepatitis or its sequelae every yearwww.who.int
What makes viral hepatitis a global health problem?
Chronic hepatitis B and C are life-threatening infectious diseases that cause serious liver damage, cancer, and premature death. More than 300 million people are living with the hepatitis B virus or the hepatitis C virus.
Hepatitis B and C are silent epidemics, hitting children and marginalized populations the hardest which include people who inject drugs, Indigenous Peoples, prisoners, men who have sex with men, migrants and people living with HIV/AIDs.
Globally, 90% of people living with hepatitis B and 80% living with hepatitis C are unaware they are living with the disease, resulting in the real possibility of developing fatal liver disease or liver cancer at some point in their lives and in some cases, unknowingly transmitting the infection to others.
With the availability of effective vaccines and treatments for hepatitis B and a cure for hepatitis C, the elimination of viral hepatitis is achievable, but greater awareness and understanding of the disease and the risks is a must, as is access to cheaper diagnostics and treatment.
Types of Hepatitis
Transmission: hepatitis A is mainly spread through eating contaminated food or drinking contaminated water. The disease is often endemic in countries with a lack of safe water and poor sanitation.
Prevention: a vaccine exists to prevent hepatitis A. Treatment within a few weeks of exposure to the virus can also bring short-term immunity. The risk of exposure can be greatly reduced by practicing good hygiene and sanitation and avoiding drinking water that has come from a potentially unsafe source.
Treatment: there is no treatment for hepatitis A. Hepatitis A only causes acute hepatitis so the body is often able to clear the infection itself within a few weeks. However, hepatitis A infection can sometimes cause further complications.
Transmission: hepatitis B is transmitted through contact with the blood or other body fluids of an infected person. For example, it can be spread from mother to child during childbirth, through sharing razors or toothbrushes, having unprotected sex, and sharing needles and syringes to inject drugs.
Prevention: hepatitis B vaccination is very effective in preventing infection. If you have not been vaccinated, it is best to use condoms and to avoid sharing needles or items such as toothbrushes, razors or nail scissors with an infected person to reduce chances of exposure. You should also avoid getting tattoos or body piercings from unlicensed facilities. If you think you are likely to be exposed in the future, vaccination is highly recommended. Children born to mothers with hepatitis B should be vaccinated within 12 hours of birth, as this can prevent an infection that is likely to progress to chronic hepatitis B.
Treatment: although there is currently no real cure for hepatitis B, drugs such as alpha-interferon and peginterferon and a variety of antiviral drugs are available. These drugs slow the replication of the virus and occasionally result in its clearance. Most importantly, they greatly reduce the risk of the complications that hepatitis B can cause such as liver cirrhosis and liver cancer.
Transmission: hepatitis C is spread through blood-to-blood contact. The most common modes of infection include unsafe injection practices, inadequate sterilisation of medical equipment and unscreened blood and blood products. It can also be transmitted through certain sexual practises where blood is involved. Whether it can be transmitted sexually without the presence of blood remains unclear. If it does happen it appears to be extremely rare although the risk may be increased by the presence of other sexually transmitted infections.
Prevention: currently there is no vaccination for hepatitis C. To reduce the risk of exposure, it is, therefore, necessary to avoid sharing needles and other items such as toothbrushes, razors or nail scissors with an infected person. You should also avoid getting tattoos or body piercings from unlicensed facilities.
Treatment: treatment can cure hepatitis C infection. Until recently treatment hs involved a combination of interferon, generally pegylated, long-lasting interferon, and ribavirin but there is increasing use of potent direct-acting antiviral drugs. People with different hepatitis C genotypes respond differently to treatment, some more successfully than others but the differences between the genotypes are disappearing as cure rates with the new drugs approach 100%.
Transmission: hepatitis D is passed on through contact with infected blood.
Prevention: hepatitis D only occurs in people who are already infected with the hepatitis B virus. People who are not already infected with hepatitis B can therefore prevent hepatitis D infection by getting vaccinated against hepatitis B. Avoid sharing needles and other items such as toothbrushes, razors or nail scissors with an infected person. You should also avoid getting tattoos or body piercings from unlicensed facilities.
Treatment: treatment for hepatitis D consists of interferon but it is not very effective.
With a person dying every 30 seconds from hepatitis-related illness – even in the current COVID-19 crisis – we can’t wait to act on viral hepatitis this World Hepatitis Day.