World Hepatitis Day: A global movement for hepatitis elimination

Viral hepatitis is the inflammation of the liver brought about by the infection of one of five viruses known as hepatitis A, B, C, D, or E. The hepatitis viral infections range from a mild hepatic inflammation, lasting for a few weeks, to chronic cirrhosis of the liver. Nevertheless, the chronic cirrhosis caused by either hepatitis B virus or hepatitis C virus leads eventually to liver cancer accompanied with a high mortality rate.

According to a recent study funded by Bill & Melinda Gates Foundation and published in journal The Lancet, viral hepatitis is considered as a leading cause of death and disability worldwide. The study reports a global increase in hepatitis deaths from 0·89 million in 1990 to 1.45 million in 2013; confronting the fact that viral hepatitis has become the seventh leading cause of death worldwide, compared with tenth in 1990.

“This is the most comprehensive analysis to date of the global burden of viral hepatitis. And it reveals startling findings – showing the death toll from this condition is now 1.45 million. Whereas deaths from many infectious diseases – such as TB and malaria – have dropped since 1990, viral hepatitis deaths have risen.” says Dr. Graham Cooke, clinical senior lecturer in infectious disease at Imperial College London and the senior author of the study.

In an attempt to raise the awareness of the viral hepatitis infection, the World Health Organization (WHO), in 2010, announced the 28th of July of each year to be the World Hepatitis Day. The WHO recognized the 28th of July to commemorate the birthday of the Nobel laureate Baruch Blumberg (1925-2011) who was the first to discover the viral hepatitis B in 1967 and to develop a hepatitis B vaccine in 1969. Since 2010, the WHO was urging a global governmental attention to promoting access to testing and executable prevention and treatment strategies.

On the 28th of May, 2016, during the 69th World Health Assembly, the member states of the WHO adopted the first global health sector strategy on viral hepatitis. The hepatitis strategy sets the first-ever global agenda to eliminate viral hepatitis B and C globally by the end of 2030.

“Although there are effective treatments and vaccines for viral hepatitis, there is very little money invested in getting these to patients -especially compared to malaria, HIV/AIDS and TB. We now have a viral hepatitis global action plan approved in May by the World Health Assembly, and we now need to implement it” adds Dr. Cooke.

According to the WHO, the hepatitis strategy targets include a 30% reduction in new cases of hepatitis B and C by 2020 and a 10% reduction in mortality. Key approaches will be to expand vaccination programs for hepatitis A,B, and E; focus on preventing mother-to-child transmission of hepatitis B; improve injection, blood and surgical safety; “harm reduction” for people who inject drugs; and increase access to treatment for hepatitis B and C. Upon successful implementation of the distinguished objectives, the global expected annual deaths will decrease by 65% with an 80% augmentation rate of effective treatment to save 7.1 million lives.

“The adoption of WHO Viral Hepatitis Strategy signals the first step in eliminating viral hepatitis, an illness which affects 400 million worldwide. We congratulate governments for showing great ambition” says Raquel Peck, CEO of the World Hepatitis Alliance. “If governments remain committed, we will witness one of the greatest global health threats eliminated within our lifetimes.”

The WHO is working closely with World Hepatitis Alliance (WHA) which is an international patient-led and patient-driven not-for-profit, non-governmental organization. Currently, the WHA has 230 members in 81 countries dedicated to fighting the disease and ensure that all countries implement the 2030 agenda. To this end, on the coming World hepatitis day, the WHA will inaugurate NOhep, the major worldwide movement aimed at gathering support for the viral elimination by 2030.

Practical information about types of viral hepatitis

Hepatitis A:

Transmission: Through food or water contaminated with feces of an infected patient. Also, raw shellfishes coming from water contaminated with sewage represent a major risk factor.

Prevention: Vaccines are available for hepatitis A. Good hygiene practices and proper sanitation largely reduces the risk of infection.

Treatment: In most of the cases, the immune system gets rid of the infection within a few weeks. Medical attention is also required to prevent any later complications.

Hepatitis B:

Transmission: Through contact with blood or body fluids of infected patients. It is transmitted also from infected pregnant mother to her child.

Prevention: Vaccines are available for hepatitis B. Avoiding risky sexual behaviors and practicing safe sex help in preventing the viral transmission.

Treatment: Different interferon and antiviral drugs are available. Newborns of infected mothers can be successfully vaccinated within 12 hours of birth.

Hepatitis C:

Transmission: Through contact with the blood of an infected patient. It is rarely transmitted through sexual contact.

Prevention: Vaccines are not available for hepatitis C. It is highly recommended to avoid sharing needles and other personal items of infected patients.

Treatment: A combination of pegylated interferon and ribavirin is commonly used. However, the genetic background of the infected patients greatly affects the treatment efficiency.

Hepatitis D:

Transmission: Through contact with the blood of an infected patient. The infection happens in patients infected already with hepatitis B virus. It is transmitted also during pregnancy.

Prevention: Vaccines are not available for hepatitis D, but hepatitis B vaccination reduces the risk of hepatitis D infection. Restriction on sharing needles and personal items of infected patients is also required.

Treatment: No antiviral drugs are available, but a-interferon helps to control the viral infection.

Hepatitis E:

Transmission: Similar to hepatitis A, the hepatitis E virus is transmitted through food or water contaminated with feces of an infected patient. Also, raw shellfishes coming from water contaminated with sewage represent a major risk factor.

Prevention: Vaccines are available for hepatitis E, but they are not widely available. Good hygiene practices and proper sanitation largely reduce the risk of infection.

Treatment: Similarly, the immune system gets rid of the infection within a few weeks.

Get yourself involved today

To register and get updates from NOhep, click here.

To apply for a membership of the WHA, click here.

To get an online training on viral hepatitis, provided by The University of Alabama at Birmingham, click here.

To get an online training on hepatitis C, provided by The University of Washington, click here.

To get an online training on viral hepatitis serology, provided by Centers for Disease Control and prevention, click here.

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