World Hepatitis Day 2020: Steps for a “Hepatitis-free future,”

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What is Hepatitis? 

Hepatitis is an inflammation (swelling) of the liver which can cause a range of health problems including liver cancer and can be fatal if not treated properly in time.

Problem statement? 

  • 325 million people are living with viral hepatitis B and C infection
  • 900,000 deaths per year caused due to infection of  hepatitis B virus 
  • Hepatitis B and C (together) are the most common cause of deaths due to hepatitis, with 1.3 million lives lost per year.
  • 10% of people living with hepatitis B and 19% living with hepatitis C know the status of their hepatitis infection
  • Only 42% of children, globally, have access to the birth dose of the hepatitis B vaccine

Reasons to celebrate Hepatitis day ? 

World Hepatitis Day is celebrated each year on 28 July by WHO to enhance awareness of viral hepatitis. This date was chosen as it the birth date of Dr Baruch Blumberg (A nobel prize winner scientist), who discovered Hepatitis B virus and also developed a diagnostic test & vaccine for the prevention of this virus.This year there is a strong focus on preventing hepatitis B among mothers and newborns.
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What are types of Hepatitis? 

According to duration of disease it is of two types 
(a)  Acute: When it lasts for <6 months
(b) Chronic: When it lasts for >6 months 

According to causative agent following types
(a) Hepatitis A
(b) Hepatitis B
(c) Hepatitis C
(d) Hepatitis D
(e) Hepatitis E
(f) Alcoholic hepatitis 
(g) Autoimmune Hepatitis 

What are symptoms of Hepatitis?

Initial/Acute symptoms are similar to flu like 
  • Muscular and joint pain
  • High grade fever (38•C /100.4 •F or above ) 
  • Not feeling well 
  • Headache 
  • Occasionally yellowing of eyes and skin
Chronic symptoms are 
  • Tired feeling all the time 
  • Jaundice 
  • Depression 
  • Not feeling well 

What are causes of hepatitis? 

  • Viruses:A,B,C,D,E
  • Bacteria: Anaplasma, nocardia
  • Alcohol 
  • Autoimmune conditions like SLE
  • Drugs like paracetamol,  amoxicycillin, ATT,  minocycline etc
  • Ischemic hepatitis due to circulatory insufficiently 
  • Metabolic diseases 
  • Pregnancy 

How to diagnose Hepatitis? 

By Clinical examination and laboratory tests like 
  • CBC
  • LFT
  • Coagulation tests
  • ELISA for specific viral antigen A, B, C, D, E
  • Liver biopsy 

How to manage hepatitis? 

  • Bed rest
  • Stop alcohol (if taking )
  • Stop causative medications (if any)
  • Symptomatic treatment to relieve symptoms 
  • Most people with hepatitis A, E get well on their own in few weeks 
  • Hepatitis B,C is treated with antiviral drugs
  • Liver transplant (in case of liver failure) 

What are preventive measures? 

Vaccination: 
  • For hepatitis A, B
General measures:
  • Wash your hands with soap and water before eating and after defeating 
  • Don't share drug needles with anyone 
  • Don't share personal items like toothbrush,  razors, nail clippers with infected persons
  • Avoid unsafe sex & use latex condoms

Steps towards Hepatitis-free future:

In the time of COVID-19 pandemic also viral hepatitis continues to claim thousands of lives every day. The most important gaps to be addressed are low coverage of testing & treatment to achieve global elimination goal by 2030. A hepatitis-free future can be achieved with a united effort. 

  • PREVENT infection among newborns: All newborns should be vaccinated against hepatitis B at birth, followed by at least 2 additional doses.
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  • STOP TRANSMISSION from MOTHER to CHILD: All pregnant women should be routinely tested for hepatitis B, HIV and syphilis and receive treatment if needed.
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  • LEAVE NO ONE BEHIND: Everyone should have access to hepatitis prevention, testing and treatment services, including people who inject drugs, people in prisons, migrants, and other highly-affected populations
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  • EXPAND access to testing and treatment: Timely testing and treatment of viral hepatitis can prevent liver cancer and other severe liver diseases.
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  • MAINTAIN essential hepatitis services during COVID-19:  Prevention and care services for hepatitis - such as infant immunization, harm reduction services and continuous treatment of chronic hepatitis B - are essential even during the pandemic.
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