ALL ABOUT HEPATITIS 

ALL ABOUT HEPATITIS

• World Hepatitis day is observed every year on July 28 to raise awareness about hepatitis.
• On World Hepatitis Day, there is always a push for more global awareness about the infection, its diagnosis, and how to prevent it.
• “Bringing hepatitis care closer to you” is the theme for the year 2022.
• It mainly aims to highlight the need to bring hepatitis care closer to the primary health care facilities, and communities, to ensure better access to treatment and care.

About Hepatitis

• Hepatitis is of five types, which are Hepatitis A, B, C, D, and E.
• Hepatitis is an inflammatory condition of the liver. It disturbs various metabolic processes such as bile production, excretion, fat and protein metabolism, activation of enzymes, and synthesis of proteins.
• 
  It can be acute that is inflammation of the liver that presents with sickness — jaundice, fever, vomiting, or even chronic inflammation of the liver that lasts more than six months, but essentially shows no symptoms.

Causes

• Usually caused by a group of viruses known as the “hepatotropic” viruses.
• Other viruses may also cause it, such as the varicella virus that causes chicken pox.
• SARS-CoV-2, the virus causing Covid-19 may also injure the liver too.
• Other causes include drugs and alcohol abuse, fat buildup in the liver, or an autoimmune process in which a person’s body makes antibodies that attack the liver.
• Hepatitis is the only communicable disease where mortality is showing an increasing trend which is a matter of concern.

Various types of hepatitis

Hepatitis A

It is an infectious disease of the liver that is caused by the Hepatitis A virus. It is acute and, in most cases, symptoms could not be recognized mainly in young people. Symptoms include vomiting, nausea, fever, severe abdominal pain, jaundice, and weakness.

Hepatitis B

it is an infectious disease caused by an infection with the Hepatitis B virus. It is contracted through flat tired wounds, contact with blood, saliva, and fluids of an infectious body. The symptoms include abdominal pain, fatigue, and jaundice.

Hepatitis C

It is an infection that is caused by the Hepatitis C virus in the liver. This can be transferred from needles that have been infected, at the time of birth, through the body fluids of an infected person, having sex with multiple partners specifically with HIV-infected persons.

Hepatitis D

It is one of the severe liver diseases that are caused by the virus Hepatitis D. It spreads from infected blood or the wound. Sometimes it might occur in conjunction with Hepatitis B.

Hepatitis E

This is a waterborne disease spread by the virus. It might be circulated through food, water, and contaminated blood. It can be either acute or chronic.

Treatment

• Hepatitis A and E are self-limiting diseases and require no specific antiviral medications.
• For Hepatitis B and C, effective medications are available.

Global Scenario

• Approximately more than 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 mainly hepatitis B and C virus.

Indian Scenario

• Viral hepatitis is caused by hepatitis viruses A through E, and it remains a major public health problem in India.
• India has “intermediate to high endemicity” for the Hepatitis B surface antigen and it is an estimated to 40 million chronic HBV infected people, constituting approximately 11% of the estimated global burden.
• The population prevalence of chronic HBV infection in India is around 3-4 %.

Challenges

• Limited availability of reliable national and state epidemiological data.
• The pocket of hyperendemicity(the term hyperendemic is used to refer to a disease that is constantly and persistently present in a population across all age groups) mainly to a tribal and isolated community.
• Access to healthcare services is often out of reach for communities as they are usually available at centralized/specialized hospitals at a cost that cannot be afforded by all the people.
• People continue to die because of the last stage diagnosis or lack of appropriate treatment. Early diagnosis is the gateway to both prevention and successful treatment.
• In the Southeast Asia region, 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.

India steps to tackle

By 2025, to reduce new infections of hepatitis B and C by 50% and 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 the appropriate treatment following steps are needed In India:

• There is a need to enhance the political commitment across all the countries of the region and it must ensure sustained domestic funding for hepatitis.
• Improving access to drugs and diagnostics by further reducing prices.
• Develop communication strategies to increase awareness.
• Innovate the service delivery to maximize the use of differentiated and people-centred service delivery options across HIV and deliver services according to people’s needs and preferences in line with the primary healthcare approach.
• Decentralising hepatitis care to peripheral health facilities which are community-based venues and locations beyond hospital sites brings care nearer to patients’ homes.
• An integrated Regional Action Plan for viral Hepatitis, HIV, and Sexually Transmitted Infection STIs 2022–2026 is being developed by WHO, which will ensure the effective and efficient utilization of limited resources available for the region and will guide countries to adopt a person-centred approach rather than a disease-specific one.
• The hepatitis B is also included under India's Universal Immunization Programme (UIP) which provides the free 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,

To achieve the global target of eliminating viral hepatitis by 2030, governments across the world have to provide adequate funding to develop a robust mechanism that effectively fights this disease.

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