May 21, 2024

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WHO ALERT ON VIRAL HEPATITIS: INSIGHTS FROM THE GLOBAL HEPATITIS REPORT 2024

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TAG: GS 3: SCIENCE AND TECHNOLOGY

THE CONTEXT: The World Health Organization (WHO) has issued a critical alert on viral hepatitis, drawing attention to the significant global burden of this infectious disease.

EXPLANATION:

  • The release of the Global Hepatitis Report 2024 provides valuable insights into the epidemiology, challenges, and strategies for combating hepatitis on a global scale.
  • With a focus on India’s high disease burden and the rising prevalence of both viral and non-viral forms of the disease, understanding the findings of this report is crucial for shaping effective public health interventions and policies.

Key Findings from the Global Hepatitis Report 2024:

  • The report underscores the alarming scale of the hepatitis epidemic, with viral hepatitis ranking as the second leading infectious cause of death globally.
  • Highlighting a staggering 1.3 million deaths per year, comparable to tuberculosis, the report reveals a concerning trend of increasing mortality attributed to viral hepatitis.
  • Hepatitis B and C account for the majority of these deaths, with an estimated 354 million people worldwide living with chronic hepatitis B or C infections.
  • Despite these grim statistics, the report also identifies areas of progress, such as improved diagnosis and treatment coverage since 2019.
  • India emerges as one of the countries with the highest disease burden of viral hepatitis, accounting for 11.6% of the global total.
  • Factors contributing to India’s vulnerability include high population density, limited awareness of symptoms, inadequate screening and treatment infrastructure, and suboptimal hygiene practices.
  • Chronic viral hepatitis B and C infections remain a significant challenge, often remaining asymptomatic for prolonged periods and perpetuating transmission due to undiagnosed cases.
  • Additionally, the rising prevalence of non-viral forms of hepatitis, such as alcoholic liver disease and non-alcoholic fatty liver disease, further exacerbates the burden on India’s healthcare system.

Prevention and Treatment Strategies:

  • Preventive measures, including vaccination for hepatitis B and access to curative treatments for hepatitis C, are essential components of effective hepatitis control strategies.
  • While the availability of affordable generic medications in India has facilitated treatment access, challenges persist in ensuring comprehensive coverage and eliminating discrimination against patients.
  • The government’s viral hepatitis control program, which includes vaccination for high-risk adults and treatment provisions, represents a step in the right direction.
  • However, sustained efforts are needed to expand access to testing, diagnostics, and equitable treatment, particularly for vulnerable populations.

Implications and Recommendations:

  • The Global Hepatitis Report 2024 serves as a call to action for governments, healthcare providers, and international organizations to prioritize hepatitis control efforts.
  • Addressing gaps in service delivery, decentralizing healthcare systems, and reducing out-of-pocket expenses for viral hepatitis services are essential steps in advancing a public health approach to combating hepatitis.
  • Furthermore, the report underscores the need for enhanced global cooperation, improved funding mechanisms, and policy reforms to achieve the ambitious goal of ending the hepatitis epidemic by 2030.
  • By adopting evidence-based interventions and fostering multisectoral collaboration, stakeholders can work towards achieving the WHO’s targets and ensuring a healthier future for all.

Hepatitis:

  • Hepatitis is an inflammation of the liver that is caused by a variety of infectious viruses and noninfectious agents leading to a range of health problems, some of which can be fatal.
  • There are five main strains of the hepatitis virus, referred to as types A, B, C, D and E.
  • While they all cause liver disease, they differ in important ways including modes of transmission, severity of the illness, geographical distribution and prevention methods.
  • In particular, types B and C lead to chronic disease in hundreds of millions of people and together are the most common cause of liver cirrhosis, liver cancer and viral hepatitis-related deaths.
  • An estimated 354 million people worldwide live with hepatitis B or C, and for most, testing and treatment remain beyond reach.
  • Hepatitis A:
    • Hepatitis A is a viral infection that affects the liver.
    • It is transmitted primarily through the consumption of contaminated water or food that has been contaminated with the feces of an infected person.
    • Poor sanitation and hygiene practices, such as inadequate handwashing after using the toilet, can contribute to the spread of the virus.
  • Hepatitis B:
    • Hepatitis B can cause a chronic infection and puts people at high risk of death from cirrhosis and liver cancer.
    • It can spread through contact with infected body fluids like blood, saliva, vaginal fluids and semen. It can also be passed from a mother to her baby.
    • Hepatitis B can be prevented with a safe and effective vaccine. The vaccine is usually given soon after birth with boosters a few weeks later. It offers nearly 100% protection against the virus.
  • Hepatitis C:
    • Hepatitis C is a viral infection that affects the liver. It can cause both acute (short term) and chronic (long term) illness. It can be life-threatening.
    • Hepatitis C is spread through contact with infected blood. This can happen through sharing needles or syringes, or from unsafe medical procedures such as blood transfusions with unscreened blood products.
    • Symptoms can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine and yellowing of the skin or eyes (jaundice).
    • There is no vaccine for hepatitis C, but it can be treated with antiviral medications.
    • Early detection and treatment can prevent serious liver damage and improve long-term health.
  • Hepatitis D:
    • Hepatitis D is an inflammation of the liver caused by the hepatitis D virus (HDV), which requires HBV for its replication.
    • Hepatitis D infection cannot occur in the absence of hepatitis B virus.
    • HDV-HBV co-infection is considered the most severe form of chronic viral hepatitis due to more rapid progression towards hepatocellular carcinoma and liver-related death.
    • Vaccination against hepatitis B is the only method to prevent HDV infection.
    • The routes of HDV transmission, like HBV, occur through broken skin (via injection, tattooing etc.) or through contact with infected blood or blood products. Transmission from mother to child is possible but rare.
    • Vaccination against HBV prevents HDV coinfection and hence expansion of childhood HBV immunization programmes has resulted in a decline in hepatitis D incidence worldwide.
  • Hepatitis E:
    • Hepatitis E is inflammation of the liver caused by the hepatitis E virus (HEV). The virus has at least 4 different types: genotypes 1, 2, 3 and 4. Genotypes 1 and 2 have been found only in humans.
    • Hepatitis E infection is found worldwide and is common in low- and middle-income countries with limited access to essential water, sanitation, hygiene and health services.
    • In these areas, the disease occurs both as outbreaks and as sporadic cases.
    • The outbreaks usually follow periods of faecal contamination of drinking water supplies and may affect several hundred to several thousand persons.
    • Some of these outbreaks have occurred in areas of conflict and humanitarian emergencies such as war zones and camps for refugees or internally displaced populations, where sanitation and safe water supply pose special challenges.

SOURCE: https://thehindu.com/sci-tech/health/why-is-there-a-who-alert-on-viral-hepatitis-explained/article68062579.ece/amp/

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