Towards a Hepatitis-free future

While the world is gripped by a novel virus, let us take a few moments to remember some of the older viruses on the occasion of World Hepatitis Day. The aim of this occasion is to enhance awareness of viral hepatitis, an inflammation of the liver that causes a range of health problems, including liver cancer.

There are five main strains of the hepatitis virus – A, B, C, D and E. Together, hepatitis B and C are the most common cause of deaths, with 1.3 million lives lost each year. Amid the COVID-19 pandemic, viral hepatitis continues to claim thousands of lives every day. Some of these deaths are directly linked to COVID-19 in patients with viral hepatitis and the others are due to collateral damage, due to lack of timely intervention and lack of screening. There has been a disruption to vaccination programes as well during the pandemic.

This year's theme is "Hepatitis-free future," with a strong focus on preventing hepatitis B among mothers and new-borns. Hepatitis C along with hepatitis B can be transmitted vertically from mother to child, but the risk is less than of hepatitis B. Other routes of transmission of Hepatitis B, C, D (which can only infect persons effected with hepatitis B) are exposure to blood or blood products, body fluids of infected persons. This is labelled horizontal transmission.

Both Vertical and horizontal transmission in Hepatitis B can be effectively prevented with a help of a safe vaccine which is >98% effective. Hepatitis A and E on the other hand are acquired from contaminated food and water. Vaccination for Hepatitis A is also available and is routinely given in childhood.

The world health organisation, has issued guidance specific to 2020 with the following themes:

Prevent infection amongst infants. All new-borns should be vaccinated against Hepatitis B and those born to mothers who test positive, will need additional immunisation with antibodies.

Test and Treat – All mothers need to be screened for Hepatitis B along with HIV and Syphilis. Mothers may be given treatment both if they are being harmed by the virus, and also to reduce the risk of transmission to the newborn.

. Everyone should have access to testing, treatment and immunization, especially the under privileged, those with history of drug abuse, prisoners etc.

Expand access to testing and treatment - This is currently being provided to high risk populations for e.g.: healthcare workers, but should be rolled out to the general population to realistically achieve a "Hepatitis free future."

Maintain essential services during COVID-19 pandemic – Services to those who are infected and those at risk of infection should be available throughout. Those with advanced liver disease are at particular risk of developing severe disease due to SARS CO-V2 and pathways should be established locally to minimize risks, e.g.: video consultations, phone follow up etc.