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Viral hepatitis is emerging as an important global public health challenge. Infectious diseases such as HIV and TB have been the hot topics for discussion, but, according to the World Health Organization (WHO), viral hepatitis is the 2nd major killer infectious disease after tuberculosis (TB), and 9 times more people are infected with hepatitis than HIV. Viral hepatitis is now the 7th most important cause of death worldwide, as per the World Hepatitis Alliance, moving up three ranks from the 10th position in 1990.
Hepatitis is preventable, treatable and in the case of hepatitis C, curable. Yet its prevalence is rising. This is because in its early stages, viral hepatitis is mostly asymptomatic. Many people are unaware that they are infected because jaundice appears only in the later stages. But asymptomatic patients are as infectious as those who have symptoms. This scenario highlights the role of “silent transmission” in spread of the disease.
It is very important to not underestimate the threat of hepatitis.
Viral hepatitis is being recognized as a major public health problem in India as well. Hepatitis A and E viruses are important causes of acute viral hepatitis and acute liver failure. Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection accounts for a large percentage of cases of hepatocellular carcinoma and cirrhosis in the country.
Viral hepatitis and HIV coinfection is a common problem and challenging to treat. Progression of liver disease is faster in individuals with HIV and viral hepatitis coinfection and they may not respond as well to treatment; they are also at increased risk for serious, life-threatening health complications. Hence, all people living with HIV should be tested for hepatitis B and C infections as well.
This year, in February, the government launched the National Action Plan - Viral Hepatitis, which provides a strategic framework, based on which National Viral Hepatitis Control Program was framed and launched last year on this day. The aim is to eliminate viral hepatitis in the country by 2030, achieve significant reduction in the infected population, morbidity and mortality associated with Hepatitis B and C viz. cirrhosis and hepatocellular carcinoma and hepatitis A and E (Press Information Bureau, February 24, 2019).
The program offers free drugs and diagnostics for hepatitis B and C besides preventive and promotive interventions, the need of the hour. Timely diagnosis means the disease can be cured.
Bangladesh, Bhutan, Nepal and Thailand have become the first countries in WHO South-East Asia Region to achieve Hepatitis B control, with the prevalence falling to less than 1% among five-year-old children.
We hope India too would soon join this list and in a step further, eliminate viral hepatitis from the country.
Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA