World Hepatitis Day 2020

Recently, COVID-19 has taken the spotlight on the infectious disease stage. However, this should not dim the light from the thousands of lives claimed by viral hepatitis every day, even amidst the current pandemic. There are 325 million people living with viral hepatitis B and C, which are the hepatitis strains that cause the greatest number of deaths (up to 1.3 million lives every year) [1]. Of those, hepatitis B alone is responsible for 900,000 deaths [1].

Hepatitis causes inflammation of the liver that can lead to a range of health complications, including liver cirrhosis and liver cancer [1]. The five main strains of the hepatitis virus are hepatitis A, B, C, D, and E, and each has its own characteristics described in table 1 of the appendix [1].

World Hepatitis Day is recognized annually on July 28th to bring awareness to this vastly underdiagnosed disease, as only 10% of people living with hepatitis B and 19% living with hepatitis C are aware of their hepatitis status [1, 2]. Worldwide, 290 million people are unaware they are living with viral hepatitis [2]. July 28th was chosen as World Hepatitis Day because it is the birthday of Dr. Baruch Blumberg, a Nobel-prize winning scientist who not only discovered the hepatitis B virus (HBV) but succeeded in developing the first vaccine [1].

Hepatitis B is most commonly transmitted from mother to child during birth and delivery so this World Hepatitis Day, the theme is a “Hepatitis-free future” to focus on preventing hepatitis B among mothers and newborns. It is found that approximately 4.5 million premature deaths could be prevented in low- and middle-income countries by the year 2030 [1]. This can be done through increased vaccination efforts, diagnostic tests, medicines, and education campaigns [1]. Globally, only 42% of children have access to the birth dose of the hepatitis B vaccine [1].

Endorsed by all WHO Member States, WHO’s global hepatitis strategy aims to reduce hepatitis incidence by 90% and deaths by 65% between 2016 and 2030, aligning with the United Nations’ Sustainable Development Goals [1]. To accomplish this, five main strategies are highlighted by the WHO, and include [1]:

1. PREVENT infection among newborns by vaccinating against hepatitis B at birth, followed by at least 2 additional doses.

2. STOP TRANSMISSION from MOTHER to CHILD. All pregnant women should be routinely tested for hepatitis B, HIV, and syphilis and receive treatment if needed.

3. LEAVE NO ONE BEHIND. Everyone should have access to hepatitis prevention, testing, and treatment services, including people who inject drugs, people in prisons, migrants, and other highly-affected populations.

4. EXPAND access to testing and treatment. Timely testing and treatment of viral hepatitis can prevent liver cancer and other severe liver diseases.

5. MAINTAIN essential hepatitis services during COVID-19. Prevention and care services for hepatitis - such as infant immunization, harm reduction services, and continuous treatment of chronic hepatitis B - are essential even during the pandemic.

In conclusion, hepatitis remains a global public health concern. Through increased messaging and awareness, reducing the incidence and deaths due to this virus can be attained, especially in infants and mothers.

Appendix

Table 1: Features of different types of viral hepatitis [3].

References

1. World Health Organization (WHO). World Hepatitis Day 2020 [Internet]. World Health Organization. World Health Organization; [cited 2020Jul25]. Available from: https://www.who.int/campaigns/world-hepatitis-day/2020

2. Time to #FindTheMissingMillions [Internet]. [cited 2020Jul25]. Available from: https://www.worldhepatitisday.org/

3. Saleem, A., Akhtar, M. F., Mushtaq, M. F., Saleem, M., Muhammad, S. T., Akhtar, B., Sharif, A., & Peerzada, S. (2016). Current trends in the treatment of hepatitis C: interventions to avoid adverse effects and increase effectiveness of anti-HCV drugs. EXCLI journal, 15, 578–588. https://doi.org/10.17179/excli2016-582