What is hepatitis?
Hepatitis means inflammation of the liver. When the liver is inflamed or damaged, its function can be affected. Viral infections, heavy alcohol use, toxins, some medications, and certain medical conditions can all cause hepatitis. This year’s theme is “Hepatitis can’t wait”, conveying the urgency of efforts needed to eliminate hepatitis as a public health threat by 2030.
Dr. Sanjeev Kumar Rastogi
Specialist Gastroenterology
There are five main strains of the hepatitis virus, referred to as types A, B, C, D and E. While they all cause liver disease, they differ in important ways including modes of transmission, severity of the illness, geographical distribution and prevention methods. In particular, types B and C lead to chronic disease in hundreds of millions of people and together are the most common cause of liver cirrhosis, liver cancer and viral hepatitis-related deaths. An estimated 354 million people worldwide live with hepatitis B or C, and for most, testing and treatment remain beyond reach.
Hepatitis C is an inflammation of the liver caused by the hepatitis C virus. The virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness to a serious, lifelong illness including liver cirrhosis and cancer. The hepatitis C virus is a blood borne virus and most infection occur through exposure to blood from unsafe injection practices, unsafe health care, unscreened blood transfusions, injection drug use and sexual practices that lead to exposure to blood.
Globally, an estimated 58 million people have chronic hepatitis C virus infection, with about 1.5 million new infections occurring per year. WHO estimated that in 2019, approximately 290 000 people died from hepatitis C, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer).
Antiviral medicines can cure more than 95% of persons with hepatitis C infection, but access to diagnosis and treatment is low. Access to HCV treatment is improving but remains too limited. In 2017, of the 71 million persons living with HCV infection globally, an estimated 19% (13.1 million) knew their diagnosis, and of those diagnosed with chronic HCV infection, around 5 million persons had been treated with DAAs by the end of 2017. Much more needs to be done in order for the world to achieve the 80% HCV treatment target by 2030.
Preventive Strategies:
Primary Prevention
There is no effective vaccine against hepatitis C; prevention of HCV infection depends upon reducing the risk of exposure to the virus in health-care settings and in higher risk populations for example, people who inject drugs and men who have sex with men, particularly those infected with HIV or those who are taking pre-exposure prophylaxis against HIV.
The following list provides a limited example of primary prevention interventions recommended by WHO:
- Safe and appropriate use of health care injections;
- Safe handling and disposal of sharps and waste;
- Provision of comprehensive harm-reduction services to people who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence;
- Testing of donated blood for HBV and HCV (as well as HIV and syphilis);
- Training of health personnel;
- Prevention of exposure to blood during sex;
Secondary Prevention
For people infected with the hepatitis C virus, WHO recommends:
- Education and counseling on options for care and treatment;
- Immunization with the hepatitis A and B vaccines to prevent coinfection from these hepatitis viruses and to protect their liver;
- Early and appropriate medical management including antiviral therapy; and
- Regular monitoring for early diagnosis of chronic liver disease
