World Hepatitis Day 2020 is an important opportunity to remind ourselves about the huge health impact of viral hepatitis in Pakistan. Several Hepatitis viruses are endemic in Pakistan including Hepatitis A, B, C and E. This is associated with significant morbidity as well as socioeconomic consequences. As per World Health Organization approximately 12 million people are living with Hepatitis B or C in Pakistan.
Hepatitis A and E mostly cause a self-limiting illness. However, these are transmitted by consuming contaminated food and water and can cause significant outbreaks. It is important to reduce risk of infection by consuming clean drinking water and practicing good food and hand hygiene.
Hepatitis B and C are of particular concern, every year approximately 150,000 new people are infected with these viruses in Pakistan.
Both Hepatitis B and C can cause a chronic infection leading to liver damage and scarring called cirrhosis, liver cancer as well as liver failure and death. In the early stage of infection, people may not have any symptoms and therefore it is common for people not to be aware that they carry the virus or have the disease.
In 2020, the theme of World Hepatitis Day is a “Hepatitis Free Future”. While the prevalence of viral Hepatitis in Pakistan is staggering and of concern, there is hope for achieving this virus free future. There is a very effective vaccination available for Hepatitis B and this has been part of the childhood Expanded Immunization Programme since 2009. As a result Hepatitis B vaccination should be offered to all children as part of their childhood vaccination programme.
For people who do develop chronic Hepatitis B infection there are effective anti-virals available to control the infection and reduce the chances of developing liver disease. There is currently no vaccine available for Hepatitis C.
However, there is highly efficacious treatment with very high cure rates following just three months of treatment with oral tablets. This treatment is usually very well tolerated with few side effects.
Alongside vaccination and treatment programmes, it is also important to raise community awareness to reduce risk of transmission.
Hepatitis B and C are transmitted through contact with contaminated blood. In Pakistan, this is most commonly associated with re-used syringes and surgical equipment as well as re-used blades at barbers. It is very important that injectable medication is appropriately used and sterile syringes and instruments are used in healthcare settings.
At Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC), we have the latest diagnostic facilities as well as clinical expertise to diagnose and manage patients with liver disease including viral hepatitis.
The author is consultant in
Gastroenterology & General Medicine at Shaukat Khanum Hospital
