Under the theme, “One Life, One Liver,” this year’s World Hepatitis Day on 28th July 2023 highlighted the importance of the liver for a healthy life, and the need to raise awareness about viral hepatitis and scale up prevention, testing and treatment to optimize liver health, prevent liver disease and attain the WHO goal of reducing new hepatitis infections by 90% and deaths by 65% by 2030.
Hepatitis literally means inflammation of the liver and may occur due to various causes among which viral hepatitis, alcohol related liver disease and fatty liver are the commonest. There are five types of hepatitis viruses ( Hepatitis A to E ) among which Hepatitis D is practically absent in India. Hepatitis A and Hepatitis E viruses causes acute hepatitis and jaundice. They are spread through feco-oral route via contaminated water and food.
Therefore, filtration or adequate boiling of drinking water, keeping food covered and other hygiene practices like washing hands with soap after going to the toilet, trimming of nails etc. are utmost important measures to prevent Hepatitis A and E. Although a vaccine is available for the prevention of Hepatitis A, as of now it has not been incorporated into national immunization schedule.
Currently, there are no approved vaccines for the prevention of Hepatitis E. Jaundice due to Hepatitis A and E viruses is usually self-limiting , resolves within a few weeks and requires only symptomatic treatment.
Only a small fraction of these patients develops acute liver failure, a devastating condition with high risk of death. However, these viruses do not cause chronic hepatitis and patients who recover do not suffer from lasting liver damage.
Unlike Hepatitis A and E, Hepatitis B and Hepatitis C viruses are notorious for causing chronic hepatitis where the virus persists in the liver and surreptitiously causes chronic liver damage which can progress to cirrhosis and liver cancer. Worlwide, it is estimated that there are more than 35 crores (350 million) patients with Hepatitis B and C with a new infection occurring every 10 seconds (i.e. 3 million every year). Most patients remain asymptomatic till they develop end-stage liver disease. Thus, many patients remain unaware of their infection and finding these missing millions, treating currently infected patients and preventing new infections remain key for tackling the scourge of viral hepatitis. Like HIV, Hepatitis B and C viruses are spread via blood and body fluids and therefore avoiding intravenous drug use, safe sexual practices, ensuring new needles/razors and sterilised medical instruments are crucial for prevention. Also, a very effective vaccine is available for prevention of hepatitis B, which requires only three doses at 0, 1 and 6 months. This vaccine has also been incorporated in the national immunization schedule. Unfortunately, there are no vaccines for Hepatitis C. Fortunately, there has been a revolution in the management of these viruses in the new millennium. Hepatitis B can be effectively suppressed and Hepatitis C can be completely “cured” in more than 95% patients using oral drugs said Dr Ajay Duseja, Professor and Head, Department of Hepatology, PGIMER, Chandigarh.
In India, it is estimated there are around 5-6 crores (50-60 million) patients with chronic viral hepatitis and testing these subjects for viral hepatitis is the only way to detect them. Viral hepatitis diagnosis and management in India is now supported by National Viral Hepatitis Control Program under the aegis of Ministry of Health and Family Welfare, Government of India. PGIMER Chandigarh serves as a Model Treatment Centre under the program for both the state of Punjab and Union territory of Chandigarh. In PGI itself, almost 150-200 new patients of Hepatitis B and C are seen per month in the liver clinic run twice a week by the Department of Hepatology of the Institute. Antiviral drugs are also distributed to around 80 to 100 new patients every month free of cost under the support of National Viral Hepatitis Control Program said Dr. Arka De, Assistant Professor, Department of Hepatology, PGIMER Chandigarh. As a Model Treatment Center, the Department of Hepatology also receives referrals of complicated cases including treatment failure, cirrhosis and liver cancer from all over India, particularly from the neighboring states of Punjab, Himachal Pradesh, Haryana, Uttarakhand, and Jammu & Kashmir. In fact, combined together both Hepatitis B and C are responsible for 60-65% of patients’ liver cancer seen in the liver clinic and are the second commonest cause for cirrhosis liver, informed Dr Duseja and Dr De.
World Hepatitis Day was launched by the World Hepatitis Alliance in 2008 in response to the concern that chronic viral hepatitis did not have the level of awareness, nor the political momentum, seen with other communicable diseases such as HIV/AIDS, tuberculosis (TB) and malaria. This is despite the fact that the number of people chronically infected with, and the number of deaths caused by, hepatitis B and C is on the same scale as these conditions.
World Hepatitis Day has generated massive public and media interest, as well as support from governments, high-profile Non-Governmental Organizations and supranational bodies, such as the World Health Organization (WHO). Every year thousands of events take place around the world, from rock concerts and press briefings to ministerial meetings and fundraising events. In May 2010, the World Health Assembly passed a resolution on viral hepatitis which, together with vital commitments on prevention, treatment and patient care, made World Hepatitis Day an official WHO awareness day. In recognition of the birthday of Professor Baruch Blumberg, who won the Nobel Prize for discovering the hepatitis B virus, WHO decided that World Hepatitis Day will take place on 28 July every year.