HEPATITIS

Source: ET

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Context

• WHO's 2024 Global Hepatitis Report underscores the significant burden of hepatitis B and C in India, with the country ranking second only to China in the number of cases.

Details

Key points highlighted in the report

• Prevalence: India accounted for 29.8 million cases of hepatitis B and 5.5 million cases of hepatitis C in 2022. Together, these infections represent a substantial portion of the global burden of viral hepatitis.
• Global Burden: Globally, an estimated 254 million people lived with hepatitis B and 50 million with hepatitis C in 2022. The number of deaths due to viral hepatitis is increasing, making it the second leading infectious cause of death worldwide.
• Chronic Disease: Hepatitis B and C can lead to chronic liver disease, including liver cirrhosis and liver cancer, contributing significantly to the global burden of these conditions. Men account for the majority of cases, and a significant portion of infections occur among individuals aged 30-54.
• Challenges: Despite progress in preventing hepatitis infections, gaps in diagnosis and treatment persist. Many individuals with hepatitis remain undiagnosed and untreated, contributing to the rising number of deaths.
• Call to Action: The WHO emphasizes the need for concerted efforts to address viral hepatitis, including expanding access to testing and treatment, strengthening prevention efforts, improving data collection, and engaging affected communities and civil society.
• 2030 Goal: The report outlines actions to advance a public health approach to viral hepatitis, with the goal of ending the epidemic by 2030. This includes addressing disparities in pricing and service delivery and overcoming funding challenges.

What is Hepatitis?

• Hepatitis is a term used to describe inflammation of the liver.
• It can be caused by various factors, including viruses, alcohol consumption, certain medications, and autoimmune diseases.
• The most common types of hepatitis are hepatitis A, B, C, D, and E, each caused by different viruses.
• Hepatitis viruses are a major public health problem worldwide, leading to acute and chronic liver diseases, including liver cirrhosis and liver cancer.

Types of Hepatitis:

• Hepatitis A (HAV):
  • Transmitted primarily through consumption of contaminated food or water.
  • Symptoms include fatigue, nausea, abdominal pain, loss of appetite, and jaundice.
  • Most cases resolve on their own without treatment, and vaccination is available for prevention.
• Hepatitis B (HBV):
  • Transmitted through contact with infected blood, bodily fluids, or from mother to child during childbirth.
  • Symptoms include fatigue, abdominal pain, dark urine, joint pain, and jaundice.
  • Can lead to chronic infection, liver cirrhosis, and liver cancer.
  • Vaccination is available and highly effective in preventing HBV infection.
• Hepatitis C (HCV):
  • Mainly transmitted through blood-to-blood contact, such as sharing needles or from infected mother to child during childbirth.
  • Often asymptomatic in the early stages.
  • Can lead to chronic hepatitis, liver cirrhosis, and liver cancer.
  • Treatment with antiviral medications has advanced significantly in recent years, leading to high cure rates.
• Hepatitis D (HDV):
  • Occurs only in individuals who are already infected with hepatitis B.
  • Transmission routes are similar to hepatitis B.
  • Can result in more severe liver disease compared to HBV infection alone.
• Hepatitis E (HEV):
  • Typically transmitted through consumption of contaminated water.
  • Symptoms are similar to hepatitis A but can be more severe, particularly in pregnant women.
  • Hepatitis E is often self-limiting, but it can cause acute liver failure in some cases.
  • Common in East and South Asia, transmitted via contaminated water. A vaccine is available in China but not yet widely accessible.

Symptoms of Hepatitis:

• Fatigue
• Jaundice (yellowing of the skin and eyes)
• Abdominal pain or discomfort
• Loss of appetite
• Nausea and vomiting
• Dark urine
• Pale-colored stools
• Joint pain
• Fever

Diagnosis:

• Blood tests to detect viral antigens, antibodies, or liver enzymes.
• Imaging tests such as ultrasound, CT scan, or MRI to assess liver condition.
• Liver biopsy may be performed to evaluate the extent of liver damage and inflammation.

Treatment:

• Treatment varies depending on the type and severity of hepatitis.
• For viral hepatitis (B and C), antiviral medications are often prescribed to suppress viral replication and reduce liver inflammation.
• Supportive care includes rest, adequate nutrition, and avoiding alcohol and certain medications that can worsen liver damage.
• In severe cases or complications such as liver failure, liver transplantation may be necessary.

Prevention:

• Vaccination is available for hepatitis A and B and is recommended, especially for individuals at higher risk of infection.
• Practicing good hygiene, such as washing hands frequently and avoiding contaminated food and water sources, can help prevent hepatitis A and E.
• Safe sex practices and avoiding sharing needles or personal items that may be contaminated are important for preventing hepatitis B and C.

Conclusion

Hepatitis is a significant global health concern, affecting millions of people each year. While vaccination and advancements in treatment have improved outcomes for many patients, raising awareness about prevention, early detection, and access to healthcare services remain crucial in the fight against hepatitis-related liver diseases.

Government initiatives to tackle hepatitis:

• National Viral Hepatitis Control Program: This program aims to eliminate viral hepatitis as a public health threat by 2030 in the country. It includes various strategies such as awareness campaigns, screening, diagnosis, treatment, and prevention measures.
• India's Universal Immunization Programme (UIP): Hepatitis B vaccination is included under India's UIP. The UIP provides free vaccination against eleven vaccine-preventable diseases, including hepatitis B, tuberculosis, diphtheria, pertussis, tetanus, polio, pneumonia, meningitis due to Haemophilus influenzae type b (Hib), measles, rubella, Japanese encephalitis (JE), and rotavirus diarrhea. This ensures widespread access to hepatitis B vaccination, particularly for children.

Sources:

Business Standard

PRACTICE QUESTION Q.  While vaccination and advancements in treatment have improved outcomes for many patients, raising awareness about prevention, early detection, and access to healthcare services remain crucial. Discuss in the context of WHO's 2024 Global Hepatitis Report. (250 Words)