Headaches caused by hepatitis in India | News explained

What is viral hepatitis?

There are five types of hepatitis viruses that cause liver disease in humans. Hepatitis A and E are transmitted through contaminated food or water and cause symptoms that last for several weeks, including fever, abdominal pain, jaundice (yellowing of the skin), dark urine, and pale stools.

However, the WHO report concerns bloodborne hepatitis B (HEP B) and hepatitis C (HEP C) viruses. Some of these viruses cause short-term infections that resolve on their own. However, some can cause lifelong chronic disease, cause cirrhosis (permanent scarring of the liver and reduced liver function), and increase the risk of liver disease. cancer.

Hepatitis B can be prevented with vaccination, but hepatitis C can be treated with medicine. This report does not take into account hepatitis D, which infects only those who are already infected with hepatitis B. Therefore, it can be prevented by vaccination against hepatitis B.

What does the report say about India?

According to the report, India has the second highest prevalence of viral hepatitis in the world, accounting for over 11% of the global burden.
Of the 254 million hepatitis B patients in the world in 2022, the number of infected people in India will be 29 million, ranking second after China (79 million). Of the 50 million hepatitis C patients worldwide, India has 5.5 million infections, second only to Pakistan's 8.8 million. Diagnosis of viral hepatitis also remained very low. According to the report, only 2.4% of hepatitis B cases and about 28% of hepatitis C cases were diagnosed.

When it comes to hepatitis C, a WHO report says India is one of the 10 countries where people who inject drugs account for 80% of infections.

This is despite the existence of national programs that provide free diagnosis and treatment for hepatitis B and C. Dr SK Sarin, deputy director of the Institute of Liver and Biliary Diseases (ILBS) and one of the people behind the country's national programme, said: Even though this program was launched in 2018, he found that its scope is still limited. “People are not taking advantage of the free diagnosis and treatment that is provided,” he says.

What is causing the increase in viral hepatitis cases in India?

Viral hepatitis can be transmitted through contaminated blood transfusions or contaminated needles.
However, Dr. Sarin said that the number of hepatitis B cases in India is increasing due to mother-to-child transmission. “Nearly 90% of hepatitis B cases in India are transmitted from mother to child. This is because most blood banks now provide safe blood and almost everyone is vaccinated, so healthcare workers can “Because needlestick infections are limited,” he said.

When it comes to hepatitis C, a WHO report says India is one of the 10 countries where people who inject drugs account for 80% of infections.

What are the challenges in dealing with viral hepatitis?

Dr Sarin says there are even more challenges to controlling hepatitis B (hepatitis C). At least he needs to ensure three things. “First, all newborns should be fully vaccinated with the hepatitis B vaccine. Second, unvaccinated adults should also be vaccinated. And anyone diagnosed with an infectious disease should be vaccinated. All should receive treatment.”

The hepatitis B vaccine was introduced for children in 2007-2008 under the government's universal immunization program. However, a 2019 study found that coverage varied between 41% and 62%. The 2018 National Viral Hepatitis Control Program also provides for vaccination of people at high risk of contracting hepatitis B, such as healthcare workers.

Regarding treatment, Dr. Sarin says: “Treatment of hepatitis B is carried out by experts according to international guidelines. The problem is that the parameters listed in the guidelines for starting treatment exclude 7-8 out of 10 people diagnosed with the infection. We need to take a “cure-all” approach, just as we did with HIV. This means anyone diagnosed with HIV should seek treatment immediately. ” Antiviral treatment for hepatitis B slows the virus' ability to damage the liver.

When it comes to hepatitis C, Dr. Sarin says making medicines available is half the battle won. “Available treatments can cure hepatitis C, and the effectiveness is 80% to 90%. Unlike hepatitis B, which requires lifelong medication, the treatment period for hepatitis C is It's for a short period of time. [12 to 24 weeks],” he explained.

How does India's response to viral hepatitis compare to its response to tuberculosis?

Importantly, this infectious disease has received less attention than tuberculosis, even though it kills almost as many people as tuberculosis. Globally, the treatment rate for tuberculosis is estimated to be around 70% in 2022, while the treatment rate for hepatitis B and hepatitis C is only 3% and 20%, respectively.

In India, the death toll from viral hepatitis was dwarfed by tuberculosis, which killed an estimated 3.31 million people in 2022, but disparities in treatment coverage remained significant. According to the report, none of the diagnosed patients were being treated for hepatitis B and only 21% were being treated for hepatitis C. Meanwhile, in India, 95% of patients diagnosed with tuberculosis received treatment.

The shortage of medicines is not the problem. According to the report, India is one of the countries with the cheapest access to medicines and diagnostics. For example, the cost of a rapid diagnostic test for hepatitis B in India was $0.09, the lowest among countries reporting this figure. Similarly, a rapid diagnostic test for hepatitis C costs just $0.21 in India, also the lowest among countries reporting this figure.

TDF treatment for hepatitis B is also available in India at a lower cost than the global benchmark price of $2.40 per month. Additionally, a 12-week course to treat hepatitis C (standard price globally is $60) is available at a cheaper price in India. In fact, several Indian drug manufacturers are producing generic versions of these drugs.