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In 2010, the World Health Organization (WHO) declared July 28th World Hepatitis Day (WHD)—one of only four official days dedicated to specific diseases. This declaration signals a serious health hazard posed by viral hepatitis B and C throughout the world.
Background: Here’s the story on this preventable problem that plagues the world. Hepatitis is a viral infection of the liver. While a quarter of infected people spontaneously get better, the rest go on to develop a chronic infection. There are various types of Hepatitis viruses (A, B, C, D, and E), but the two that are particularly dangerous are Hepatitis B and C. Both viruses, if untreated, can lead to cirrhosis of the liver, and in the case of Hepatitis B, cancer of the liver. These two strains are transmitted mainly through blood but in some cases other body fluids such as semen. One difference between hepatitis B and C is that there is a vaccine to prevent Hepatitis B, but there is no treatment or cure. Conversely, there is no vaccine for Hepatitis C, but there is a cure in approximately 90% of cases.
Back to World Hepatitis Day: On May 2016, the sixty-ninth World Health Assembly launched the first “ Global Health Sector Strategy on viral hepatitis for 2016-2021”. This is the first campaign to address hepatitis at both the national and international level. The “Know hepatitis-Act now” initiative aims to cut new cases of hepatitis B and C by 30%, as well as reduce mortality by 10%, by the year 2020 .
This is a big undertaking but a worthy one, which focuses on education on prevention, testing, and treatment. So, in honor of WHD, here’s a quick primer on the two worrisome strains of Hepatitis.
Why Hepatitis, Why Now? The WHO is making a big deal about this virus, now, because 400 million people in the world are believed to be infected with it, and 1.4 million people die from it each year--which kind of makes it an epidemic. In the United States, the CDC estimates that 2.7-3.9 million people have chronic Hepatitis C, while 850,000-2.2 million people have chronic Hepatitis B.
To make matters worse, it is estimated that 95% of infected people throughout the world may not even be aware that they have it. In the case of Hepatitis C, it may be over 20 years before the liver gets affected. But, why wait 20 years, when there is a treatment or even a cure today?
The Good News: Both Hepatitis A and B may be prevented, either through vaccination (Hep B), or avoidance of known sources of exposure (both). The “Know hepatitis-Act now” initiative emphasizes education for all, and testing for those at risk. Those considered “at risk” include, partners of infected persons, injection drug users, those who share needles or other drug paraphernalia--basically anyone who may be exposed to blood products or certain body fluids of an infected individual.
Baby Boomers : As of 2013, the US Preventative Task force (USPSTF) recommends that ALL baby boomers--adults in the US born between the years 1945 and 1965-- get a one-time screening blood test for Hepatitis C, while everyone else gets periodic testing based on risk. This recommendation resulted from a National Health and Nutrition Examination Survey (NHANES) data from 2003-2010, which showed that the baby boomer group comprised 81% of the Hepatitis C positive population.
The theory behind this finding is that many baby boomers were exposed to the virus in the 1970s and 1980s—a time when hepatitis C infection was most prevalent. Another presumption is that the same group was exposed to blood transfusions before standardized blood donor testing, for the virus, was adopted in 1992.
Since the USPSTF screening guidelines were issued, Medicare has approved payment for a one-time screening blood test for baby boomers.
Treatment: Getting timely treatment, before the virus does any serious damage to the liver, is key. This of course mainly applies to hepatitis C, as there is no treatment—yet—for Hepatitis B. Fortunately, childhood vaccination for Hepatitis B has led to a decline in the rate of this infection. There have been a lot of recent advances in the treatment of Hepatitis C. There are now several medications on the market that can cure Hepatitis C in approximately 90% of the cases.
References:
(2) http://www.who.int/campaigns/hepatitis-day/2016/event/en/
