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WHO urges action against hepatitis viruses

26 July, 2013

KARACHI: World Health Organisation (WHO) is urging governments, in connection with World Hepatitis Day on July 28, to act against the five hepatitis viruses that can cause severe liver infections and lead to 1.4 million deaths every year.

Some of these hepatitis viruses, most notably types B and C, can also lead to chronic and debilitating illnesses such as liver cancer and cirrhosis, and in addition to this, loss of income and high medical expenses for hundreds of millions of people worldwide.

Viral hepatitis is referred to as a 'silent epidemic' because most persons do not realise that they are infected and, over decades, slowly progress to liver disease. Many countries are only now realising the magnitude of the disease burden and devising ways to address it.

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 can be prevented by reaching every child with immunisation programmes that include hepatitis B vaccine. 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, transfusion services, organ donation and injection practice.

Hepatitis A and E can be prevented by avoiding contaminated food and water; in addition, there is an effective WHO approved vaccine for hepatitis A. Hepatitis medicines are now included in the WHO Essential Medicines List, which Member States are encouraged to adopt. Essential medicines are selected based on disease prevalence, safety, efficacy, and comparative cost-effectiveness. The WHO Model List can be used by countries as a guide for the development of their own national list.

"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," says WHO Assistant Director-General for Health Security and the Environment Dr Keiji Fukuda.

The findings show that 37 percent of the countries have national strategies for viral hepatitis, and more work is needed in treating hepatitis. It also highlights that while most of the countries (82 percent) have established hepatitis surveillance programmes, only half of them include the monitoring of chronic hepatitis B and C, which are responsible for most severe illnesses and deaths.

"Many of the measures needed to prevent the spread of viral hepatitis disease can be put in place right now, and doing so will offset the heavy economic costs of treating and hospitalising patients in future," says Director Pandemic and Epidemic Diseases at WHO Dr Sylvie Briand. "The findings underline the important work that is being done by governments to halt hepatitis through the implementation of WHO recommended policies and actions," she added.

WHO is currently developing new hepatitis C screening, care and treatment guidelines, which will provide recommendations on seven 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," says Team lead of WHO's Global Hepatitis Programme Dr Stefan Wiktor.

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