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VIRAL HEPATITIS AND WHO ALERT: BASIC INFORMATION



  Apr 19, 2024

VIRAL HEPATITIS AND WHO ALERT: BASIC INFORMATION



What is Viral Hepatitis?

Viral hepatitis is an inflammation of the liver caused by infection with one of the five main hepatitis viruses: A, B, C, D, and E. Each virus is distinct in its transmission route, the severity of the liver disease it causes, and its epidemiological profile.

Types of Hepatitis Viruses:

Hepatitis A: Often spread through ingestion of contaminated food or water. It generally causes a self-limited disease that does not lead to chronic infection.

Hepatitis B: Transmitted through contact with infectious body fluids, such as blood, vaginal secretions, or semen, often through sexual contact or from mother to child at birth. It can lead to chronic infection and poses a high risk of death from cirrhosis and liver cancer.

Hepatitis C: Mainly spread through blood-to-blood contact such as sharing needles and less commonly through sexual contact. Hepatitis C can lead to chronic liver disease.

Hepatitis D: Only affects people who are already infected with Hepatitis B. The dual infection of HDV and HBV can result in a more severe disease and worse outcome.

Hepatitis E: Primarily transmitted through consuming contaminated water and is prevalent in regions with poor sanitation. Generally results in a self-limited infection, although it can be severe in pregnant women.

Symptoms of Viral Hepatitis:

Common symptoms include jaundice (yellowing of the skin and eyes), abdominal pain, fatigue, loss of appetite, nausea, vomiting, and fever. However, many individuals, especially those with hepatitis B or C, may remain asymptomatic for years.

Diagnosis and Treatment:

Diagnosis: Generally involves blood tests to detect presence of viral antigens or antibodies, and additional tests to assess liver function and damage.

Treatment: Varies with the type of hepatitis:

♦ Hepatitis A and E typically do not require treatment as the infection is usually self-limiting.

♦ Hepatitis B is treated with antiviral drugs and monitoring to prevent liver damage.

♦ Hepatitis C can often be cured with antiviral medications taken over several weeks.

♦ Hepatitis D treatment involves medications used for hepatitis B as well as liver transplantation in severe cases.

Prevention:

♦ Vaccines are available for hepatitis A, B, and E.

♦ Hepatitis C and D do not have vaccines, but their transmission can be reduced through screening of blood products, safe injection practices, and harm reduction services for those who inject drugs.

Global Impact:

♦ Viral hepatitis remains a major public health challenge globally, particularly hepatitis B and C, which lead to chronic disease and are the most common cause of liver cirrhosis and cancer.

♦ Understanding viral hepatitis can lead to better preventive measures, early detection, and effective management of the disease, reducing the overall health burden.

VIRAL HEPATITIS IN INDIA

What is the recent WHO alert on viral hepatitis about?

The World Health Organization (WHO) has issued alerts on viral hepatitis due to its significant global impact and the alarming number of deaths it causes annually. The recent Global Hepatitis Report 2024 highlights viral hepatitis as a leading infectious cause of death, comparable to tuberculosis, emphasizing the urgent need for improved diagnostic, treatment, and prevention strategies.

Why is India highlighted in the Global Hepatitis Report 2024?

India is under the spotlight due to its substantial share of the global viral hepatitis burden, holding 11.6% of the total cases worldwide. The high disease load in India is attributed to factors such as high population density, inadequate screening, and low awareness about the disease and its transmission.

What does the report say about the disease load of hepatitis B and C in India?

The report indicates a high prevalence of chronic hepatitis B and C in India, with many cases remaining undiagnosed due to asymptomatic nature of the infections and insufficient screening programs. This undetected reservoir contributes to ongoing transmission and a rising disease burden.

Is there an increase in non-viral hepatitis cases in India?

Yes, the report notes an increase in non-viral forms of hepatitis, such as alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD), primarily due to lifestyle changes including high alcohol consumption, obesity, and metabolic disorders. These conditions exacerbate the overall hepatitis burden by progressing to severe liver diseases.

How can hepatitis B and C be prevented and treated in India?

Prevention of hepatitis B is primarily through vaccination, which is part of the government's immunization program. Hepatitis C, while curable with medication, highlights the need for accessible and affordable treatment options. The government’s viral hepatitis control program plays a critical role in providing vaccinations and treatments, particularly to high-risk groups and healthcare workers.

What are the key takeaways from the WHO report regarding global efforts?

The report underscores the necessity for global and national efforts to enhance service coverage and access to affordable medications. It reveals that diagnosis and treatment rates for hepatitis are below the WHO's 2030 target, pointing to a need for increased efforts in testing, treatment accessibility, and preventive measures to combat the viral hepatitis epidemic effectively.

The WHO report serves as a crucial document for guiding future strategies in the fight against viral hepatitis, urging countries to adapt public health approaches that can significantly reduce the disease burden by 2030.



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