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Hepatitis B, C Remain A Concern In Country: Study

With 1.5 lakh deaths annually and almost 60 million Indians affected, viral hepatitis, particularly hepatitis B (HBV) and C (HCV) — inflammation of liver — continues to be a serious public health concern in the country. However, what is the more worrying is that over 80 per cent of the infected people aren’t aware of their infection.

Globally, viral hepatitis B and C affect about 325 million people globally, causing 1.4 million deaths. It is the second major killer infectious disease after tuberculosis. Nine times more people are infected with hepatitis than HIV.

Given that the HCV is more deadly scourge when compared with other viral hepatitis infections, a study has said if the comprehensive package of prevention, screening, and treatment interventions to tackle the former is not fully implemented in China, India, or Pakistan — the countries of highest projected future cases — the WHO goals on HCV elimination would remain unachievable.

The WHO goal of eliminating HCV as a public health threat is to reduce incidence by 80 per cent and mortality by 65 per cent by 2030. According to an estimate, HCV infects more than 70 million people worldwide and ultimately causing liver complications including cirrhosis and cancer in 10-20 per cent of cases.

No doubt, the discovery of direct-acting antiviral (DAA) drugs in 2014 gave new hope to the fight against HCV, inspiring the WHO to set the elimination goals. However, researchers from Imperial College London’s School of Public Health after examining the feasibility of achieving the WHO target noted that while the DAA offers a promising means of treating HCV cases, it does not directly reduce the transmission of the virus, which is typically associated with blood transfusions, healthcare-related injections, and injection drug use.

On the other hand, said the researchers after working on all the models, if the comprehensive package is not fully implemented in China, India, or Pakistan — the countries of highest projected future cases — the global incidence would be increased only 69 per cent by 2030, pushing back the achievement of these goals to 2047. Thus, the study underscores the importance of action in these specific countries to achieve the WHO goals on HCV elimination.

The study, which has been published in The Lancet was funded by the Wellcome Trust and conducted by researchers from the MRC Centre for Global Infectious Disease Analysis at Imperial College London, including lead author Dr Alastair Heffernan.

There is no vaccine for hepatitis C and the only prevention is by not using infected blood and needles. Fortunately, the treatment of hepatitis C has become very easy and affordable (a 12-week course, costs less than 4,000 and is effective in 95 per cent of patients), said Dr SK Sarin, hematologist and director of Delhi-based Institute of Liver & Biliary Sciences (ILBS) which has launched a year-long countrywide campaign — EMPATHY (Empowered People Against Hepatitis) to raise awareness about the disease.

Diagnosis and drugs for both hepatitis B and C are readily available and, under National Viral hepatitis Control Program, are free for everyone. However, Dr Sarin said, “India is facing three main challenges in the elimination of these deadly viruses: First, to find those who are infected. The high-risk groups for hepatitis B include infected mothers and all family members, and for both hepatitis B and C, subjects receiving blood transfusions, injections, and infected with HIV.”

There are five types of viral hepatitis infections – A, B, C, D and E. Over 95 per cent of deaths are caused by chronic hepatitis B and C infections, while hepatitis A and E rarely cause life-threatening illnesses. Hepatitis D is an additional infection occurring in people living with hepatitis B. – The Pioneer