World Hepatitis Day

• 28 Jul 2022

For Prelims: Hepatitis Day, Hepatotropic Virus, Other Diseases, Hepatitis B

For Mains: Prevalence of Hepatitis at Global and Indian level, Challenges in tackling Hepatitis and how to achieve the global target

Why in News?

World Hepatitis Day is observed each year on 28^th July to enhance awareness of viral hepatitis.

• The theme for the year 2022 is “Bringing hepatitis care closer to you”.
  • It aims to highlight the need to bring hepatitis care closer to primary health care facilities, and so communities, to ensure better access to treatment and care.

What do we need to know about Hepatitis?

• Hepatitis:
  • The word hepatitis refers to any inflammation of the liver — the irritation or swelling of the liver cells from any cause.
  • It can be acute (inflammation of the liver that presents with sickness — jaundice, fever, vomiting) or chronic (inflammation of the liver that lasts more than six months, but essentially showing no symptoms).
• Causes:
  • Usually caused by a group of viruses known as the “hepatotropic” (liver directed) viruses, including A, B, C, D and E.
  • Other viruses may also cause it, such as the varicella virus that causes chicken pox.
    • SARS-CoV-2, the virus causing Covid-19 may injure the liver too.
  • Other causes include drugs and alcohol abuse, fat buildup in the liver (fatty liver hepatitis) or an autoimmune process in which a person’s body makes antibodies that attack the liver (autoimmune hepatitis).
  • Hepatitis is the only communicable disease where mortality is showing an increasing trend.
• Treatment:
  • Hepatitis A and E are self-limiting diseases (i.e. go away on their own) and require no specific antiviral medications.
  • For Hepatitis B and C, effective medications are available.
• Global Scenario:
  • 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.
• 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.
  • Population prevalence of chronic HBV infection in India is around 3-4 %.
• Challenges:
  • Access to healthcare 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. Early diagnosis is the gateway for 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.

What is the Global Target for Hepatitis?

• About:
  • The Global Target is to eliminate viral hepatitis as a public health threat by 2030.
• How to achieve the Target:
  • By 2025, we must reduce new infections of hepatitis B and C by 50%, 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.
  • There is a 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.
    • Innovate service delivery to maximise 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, 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.
    • This will ensure effective and efficient utilisation of limited resources available for the region and will guide countries to adopt a person-centred approach rather than a disease-specific one.

Way Forward

• 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.

Note:

• 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.
• Bangladesh, Bhutan, Nepal and Thailand became the first four countries in the World Health Organization’s Southeast Asia region to have successfully controlled Hepatitis B.
• Recently, an automated coronavirus testing device named ‘COBAS 6800’ was launched which can also detect viral Hepatitis B & C, among others.
• It can be noted that only for four diseases viz. HIV-AIDS (1^st December), TB (24^th March), Malaria (25th April), and Hepatitis, the World Health Organization (WHO) officially endorses disease-specific global awareness days.

UPSC Civil Services Examination, Previous Year Questions (PYQs)

Q. Which one of the following statements is not correct? (2019)

(a) Hepatitis B virus is transmitted much like HIV.
(b) Hepatitis B unlike Hepatitis C, does not have a vaccine.
(c) Globally, the number of people infected with Hepatitis B and C viruses arc several times more than those infected with HIV.
(d) Some of those infected with Hepatitis B and C viruses do not show the symptoms for many years.

Ans: (b)

Explanation:

• Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. The virus is transmitted through contact with the blood or other body fluids of an infected person, much like HIV transmission.
• A vaccine against Hepatitis B has been available since 1982. The vaccine is 95% effective in preventing infection and the development of chronic disease and liver cancer, due to which it came to be known as first ‘anti-cancer’ vaccine.
• According to the WHO data, an estimated 296 million people are living with Hepatitis B, whereas an estimated 58 million people have chronic Hepatitis C infection. There were approximately 37.7 million people living with HIV at the end of 2020 with 1.5 million people becoming newly infected in 2020 globally.
• Hepatitis C is a liver disease caused by the Hepatitis virus, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness. The Hepatitis C virus is a blood borne virus and the most common modes of infection are through exposure to small quantities of blood. This may happen through drug use, unsafe injection practices, unsafe health care, and
• the transfusion of unscreened blood and blood products. Sometimes Hepatitis B and C viruses do not show the symptoms for many years.
• Therefore, option (b) is the correct answer.

Source: TH