On World Hepatitis Day, WHO calls for expanded detection and treatment of viral hepatitis, warning that if current infection trends continue, by 2040 they could kill more people than the world. malaria, tuberculosis and HIV together.
“Hepatitis causes liver damage and cancer, claiming the lives of more than a million people each year. Of the five types of hepatitis, types B and C cause the most illnesses and deaths. Although hepatitis C can be cured, only 21% of infected people are diagnosed and 13% have received curative treatment. As for chronic hepatitis B, only 10% of infected people are diagnosed, and only 2% of these receive life-saving medication,” declared the WHO.
THE AMOUNT
Only 11% of people with HBV know their status. That is, 1 in 5 people are aware of having the infection.
Under the motto “One life, one liver”, the WHO stresses this year the importance of protecting the liver against hepatitis to lead a long and healthy life. “There are millions of people around the world with undiagnosed and untreated hepatitis, despite the fact that we have better tools for prevention, diagnosis and treatment than ever before. WHO remains committed to helping countries scale up the use of these tools, particularly increasingly cost-effective curative medicines, to save lives and end these diseases,” said Dr. Tedros Adhanom Ghebreyesus, WHO director-general.
To reduce new infections and deaths from hepatitis B and C, it is essential that countries act on several fronts. First, they must ensure that all infected pregnant women receive adequate treatment, thus avoiding vertical transmission to their children. In addition, it is crucial to ensure that all newborns receive the hepatitis B vaccine to prevent new infections.
What are the symptoms of hepatitis?
Some people with hepatitis have no symptoms and do not know they are infected. However, others that present symptoms may include:
Photo: Altamed Fever Fatigue Loss of appetite Nausea and/or vomiting Abdominal pain Dark urine Clay-colored stools Joint pain Jaundice (yellowing of the skin and eyes)
On the other hand, it is necessary to improve diagnostic systems so that at least 90% of people with hepatitis B or C are identified and can receive timely treatment. Likewise, the treatment of 80% of the people diagnosed should be prioritized to improve their quality of life and stop the progression of the disease.
Safety precautions protocol should also be strictly implemented when administering injections, thus avoiding infection transmission in healthcare settings.
Lastly, it is vital to work on reducing risk factors and promoting health education to prevent damage associated with these diseases. These joint and coordinated actions by countries and health organizations will bring us closer to the goal of eliminating hepatitis B and C by the year 2030.
Protecting the liver: Vaccines, tests and treatments
Photo: GOOSE
“Vaccinating children against hepatitis B is essential to limit viral hepatitis infections in general. Although this is the only Sustainable Development Goal (SDG) health target to be achieved by 2020 and on track to be achieved by 2030, many African countries do not have hepatitis B vaccines given to newborns . Gavi’s recent resumption of its vaccine investment strategy launched in 2018, which includes delivery of vaccines, will help reactivate newborn vaccination programs in West and Central Africa, where rates of mother-to-child transmission of hepatitis B are still very high,” explained the WHO.
This disease can be transmitted from mother to child during pregnancy or childbirth, which is known as mother-to-child transmission. The World Health Organization (WHO) recommends that all pregnant women be screened for hepatitis B during pregnancy. If the result is positive, it is essential that they receive adequate treatment to reduce the viral load and therefore the risk of transmission to their baby during delivery.
In addition to treating mothers, WHO also recommends that all newborns born to mothers with hepatitis B receive the vaccine to help eliminate mother-to-child transmission.
However, despite these WHO recommendations, reality shows that only 32 of the 64 countries that have developed regulations aimed at eliminating mother-to-child transmission of hepatitis B carry out detection and treatment activities in antenatal clinics. Clearly, this represents an obstacle to achieving disease elimination goals.
According to a recent study, 80% of the 103 countries that participated in the questionnaire test and treat hepatitis B in HIV care units. In the case of hepatitis C, this percentage drops to 65%.
For this reason, it is critical to integrate hepatitis testing and treatment into HIV programs. In this way, protection will be provided to HIV-seropositive people, avoiding the appearance of liver cirrhosis and liver cancer.
“Testing can help create the link between treatment and medical care to make it more accessible to millions of people living with hepatitis. And for those living with chronic HBV or HCV infections, doctors use molecular tests to assess how they are responding to treatment.” explained Oscar Guerra, Medical Director for Rapid Diagnostics at Abbott.
Expanding hepatitis testing and treatment within HIV programs is essential to protect HIV-positive people from developing liver cirrhosis and liver cancer.
In colombia
Other data of interest on the cases of hepatitis C in the country are: 60.51% of people diagnosed are coinfected with HIV, 52.23% of those affected reside in Bogotá, 87.58% are part of the contributory regime.
In the country, hepatitis C experienced an increase in prevalence between 2020 and 2021, going from 1.36 to 2.5 cases per 100,000 inhabitants. Yet surprisingly, only 15% of people diagnosed with hepatitis C are aware of their condition. In addition, the disease shows a significant lethality, registering 7.08 deaths for every 1,000 people diagnosed with chronic hepatitis C.
THE AMOUNT
Between January 1 and December 31, 2022, 1,863 cases of chronic hepatitis C were registered, indicating an increase of 42.65% compared to the previous period. In addition, there was an increase of 45.60% in cases of chronic hepatitis C in men, while in women the increase was 33.01%.
The most common routes of infection are blood transfusions and sexual transmission. In the case of men, HCV transmission occurs mostly through sexual transmission, while in women it is due to blood transfusion.
At the territorial level, Bogotá DC is the place with the greatest relevance for the entity, accompanied by Risaralda and Quindío; based on the number of people diagnosed.
Although the follow-up of patients undergoing treatment should be around 8 to 10 months, the CAC has identified that the time is prolonged, generally due to clinical management.
Regarding care for hepatitis C, in 2022, 33.76% of prevalent cases received at least one care for general medicine, 43.27% at least one care for infectious diseases, 12.73% at least one care for hepatology, a minimum of 2.78% gastroenterology care, a minimum of 1.34% internal medicine care and a minimum of 0.81% family medicine care. And with regard to the medical specialty, hepatology had a higher average number of consultations 1.67 for patients with uncompensated cirrhosis, while gastroenterology had a higher average number of consultations in compensated patients.
Therefore, for the indicators at the national level to improve, it is necessary to improve the screening campaigns and the search for possible patients with hepatitis C, especially in specific populations.
So far in 2023, a total of 970 cases of hepatitis have been reported, of which 642 are hepatitis B and 328 are hepatitis C, according to data from the National Institute of Health. Of the total cases, 61.3% correspond to men and 38.7% to women.
In recent years, the number of people accessing curative treatments for hepatitis C has been increasing, but this trend is slowing.
drug prices
Photo: So Let’s Go in Health
The WHO suggests taking advantage of the reductions in the prices of medicines to promote the expansion of access to these treatments. For example, in low-income countries, a 12-week regimen to cure hepatitis C costs US$60, compared with more than US$90,000 when it was first introduced in higher-income countries. income. Hepatitis B treatment, on the other hand, costs less than US$30 per year (approximately US$2.4 per month).
These significant cost reductions make treatments more affordable and accessible to populations in low-income countries, facilitating the expansion of hepatitis treatment and prevention programs.