Hepatitis leads to 1.4m deaths annually – WHO

During celebrations to mark world Hepatitis day recently, the World Health Organisation (WHO) urged governments to act against the five hepatitis viruses that cause severe liver infections and lead to over 1.4 million deaths each year. 

The complexity of hepatitis disease lies in the existence of different types of viruses. The director Pandemic and Epidemic Diseases at WHO, Dr Sylvie Briand, says Hepatitis A and E are food borne and waterborne infections, which cause millions of cases of acute illness every year, sometimes with several months needed for a person to fully recover.

Hepatitis B, C, and D are spread by infected body fluids including blood, by sexual contact, mother-to-child transmission during birth or by contaminated medical equipment. 

Hepatitis B and C have a greater health burden in terms of death because they can cause chronic infection, which can lead to liver cirrhosis (chronic liver disease characterised by replacement of liver tissue) and cancer.

Viral hepatitis is ‘silent epidemic’ because most persons do not realise that they are infected and, over decades, slowly progress to liver disease.

“The fact that many hepatitis B and C infections are silent, causing no symptoms until there is severe damage to the liver, points to the urgent need for universal access to immunisation, screening, diagnosis and antiviral therapy,” said Dr Keiji Fukuda, WHO Assistant Director General for Health Security and the Environment.

The challenges posed by hepatitis were formally acknowledged by the World Health Assembly in 2010, when it adopted its first resolution on viral hepatitis, and called for a comprehensive approach to prevention and control. 

WHO has been collaborating closely with countries and partners to build a strong global response and is currently developing new hepatitis C screening, care and treatment guidelines, which will provide recommendations on key areas such as testing approaches; behavioural interventions (alcohol reduction); non-invasive assessment of liver fibrosis; and the selection of hepatitis C drug combinations.

“New, more effective medicines to prevent the progression of chronic hepatitis B and C are in the pipeline. 

However, these will be expensive and therapy will require monitoring with sophisticated laboratory tests. To cure and reduce the spread of these viruses, medicines must become more accessible,” said Dr Stefan Wiktor, Team lead of WHO’s Global Hepatitis Programme.

In June 2013, the organisation launched the Global Hepatitis Network with aims of supporting countries with planning and implementation of viral hepatitis plans and programmes. 

WHO-approved vaccines are available to prevent hepatitis A and B, while screening of blood donors, assuring clean needles and syringes, and condom use, can prevent transmission of the disease.

Prevention

In a recent WHO report dubbed, ‘Global policy report on the prevention and control of viral hepatitis, Hepatitis B can be prevented by reaching out to every child with immunisation programmes.

However, there is no vaccine for hepatitis C. In addition, infections can be prevented by protecting against mother-to-child transmission of the virus and ensuring the safety of blood during transfusion services, organ donation and injection practice. Hepatitis A and E can be prevented by avoiding contaminated food and water.