Hundreds of millions of people worldwide, chronically suffer from Hepatitis each year. With a person dying every 30 seconds from a hepatitis related illness – even in the current COVID-19 pandemic – one cannot neglect its severity.1 The major challenge we face in eradicating this disease today is to preventing the fatality of chronic infection and avoiding acute infection in at-risk populations.2
We celebrate the World Hepatitis Day on 28th July every year on the birthday of Dr. Baruch Blumberg. Dr. Blumberg discovered Hepatitis B virus (HBV), and developed a diagnostic test and vaccine for the virus. This day is to recognize the severity of the viral hepatitis and spread awareness to control its ill effects worldwide.3
Global health sector strategy on Viral Hepatitis 2016-21, designed by WHO aims to eliminate viral hepatitis by 2030. The target is 10% reduction of hepatitis B and C by 2020 and 65% by 2030. The 2019 WHO global data indicates 3 million new infections and 1.1 million deaths due to HBV and HCV, which despite being a good trajectory, falls significantly short of the target.4
What is Hepatitis?
Literally speaking, ‘Hepa’ means ‘Liver’ in Greek and ‘-itis’ refers to ‘inflammation’. This inflammation of liver could either be a result of a preceding autoimmune disease, toxic substances (like alcohol, drug overdose or overuse, exposure to poisons etc.) or Viral infection. The most common cause of Hepatitis is Viral infection.
Fever, fatigue, loss of appetite, abdominal pain, dark urine, light-coloured stools, jaundice are some symptoms that must be looked out for, as it could take as long as a decade to detect chronic Hepatitis.5
What are the different types of Hepatitis?
Based on virus, there are 5 types of hepatitis infection; A, B, C, D and E. Of these, type A and E are always acute and Hepatitis B, C, and D are mostly chronic.6
Type G, also commonly known as GB virus-C, is a co-infection of other viruses (B, C or HIV). Not much is known about HGV yet, hence, there is no professionally recommended treatment available. Prevention similar to other hepatitis infections is however suggested.7
It is evident from figure 1, that HBV is the major cause of viral hepatitis-related deaths. And, vaccination is the mainstay of HBV infection prevention. Scaling up the coverage of HBV vaccine is crucial also because HDV infection occurs simultaneously or as a sub-infection of it. Coverage of 3 doses of HBV vaccines reached 85% globally in 2019, from 30% in 2000. This vaccine drive has considerably brought down the spread of HBV infection with time tested, innovative vaccines.8
Other types of Hepatitis
Autoimmune and Alcoholic are the two other kinds which unlike viral hepatitis are non-infectious.9
Autoimmune hepatitis is the result of immune system dysfunction. Here, the individual’s immune system misconceives its own liver as a threat and forms antibodies against the liver. Typically, immunosuppressants are prescribed as treatment.9
Alcoholic hepatitis is caused by excess consumption of alcohol. It harms the liver by injuring the liver cells, leading to liver failure and cirrhosis. Quitting or controlling alcohol intake can prevent the adversity of it.9
How is Hepatitis diagnosed?
Hepatitis infection is diagnosed after a series of tests by physicians. These tests include liver biopsy, abdomen checkup, serological tests, and ultrasound. As most of the hepatitis infections are asymptomatic, only about 2/3rd of the infected individuals gets diagnosed. And timely diagnosis is crucial to determine if the infection is acute or chronic for receiving effective treatment.2
Depending on the type of hepatitis infection, its treatment differs. It could be prevented by immunization (administering vaccines) and by taking lifestyle precautions.8 Vaccines are only available for HAV and HBV. 9
What is the global landscape of hepatitis?
Numerous companies are designing, manufacturing and supplying viral hepatitis vaccines. And, several campaigns and vaccination programs are conducted across the globe to recognize the seriousness of the hepatitis infection.
The prevalence of HBV infection has decreased in children, owing to spreading awareness by encouraging vaccination. As a result, the incidence of HBV worldwide was reduced 30%, meeting the WHO strategy target. However, urgent actions are needed to bring further down the count of HBV infections.4,10
The HCV infection worldwide has decreased notably. The numbers went down to 58 million people with chronic HCV infection in 2019, from 71 million in 2015, and, the number went up for receiving curative treatment for chronic HCV infection to 9.4 million in 2019, down from 1 million in 2015! This progress was possible due to rigorous treatment campaigns conducted in 6 countries in particular, Egypt, India, Brazil, China, Pakistan and Georgia.4
On account of the current COVID-19 pandemic, hepatitis crisis has taken a backseat and the vaccination drives and treatment campaigns are disrupted. Hepatitis can’t wait! This is the time for us to collectively contribute to the wellness of our society by taking all the needed preventions to eradicate the Hepatitis disease.
- Figure 3 –https://www.cdc.gov/hepatitis/index.htm
- Figure 4 –https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/hepatitis-b