World Hepatitis Day is July 28. Recent data published by the World Health Organization (WHO) estimates that there are 325 million people worldwide living with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. According to the WHO Global Hepatitis Report 2017, a large majority of people with viral hepatitis lack access to testing and treatment. This puts millions at risk of chronic liver disease, cancer, and death. Vaccines and medicines can prevent this.
In 2015, approximately 1.34 million people died because of viral hepatitis. This mortality rate is comparable to the number of deaths caused by tuberculosis and HIV. A big difference between these diseases is that TB and HIV mortality rates are decreasing while hepatitis-related deaths are increasing. Only 11 percent of people living with HBV and/or HCV are aware of their status.
New HCV infections are increasing. In 2015, there were roughly 1.75 million new HCV infections. Globally, there are approximately 71 million people living with HCV. There is no vaccine against HCV, and access to treatment for it is low.
Routine vaccination has caused the rate of new HBV infections to decline. Approximately 84 percent of children born in 2015 were vaccinated against hep B. However, many people were born before the days of routine HBV immunization. Thus, 257 million people are living with chronic HBV infection; access to HBV treatment is low.
The goal of WHO’s Global Health Sector Strategy on viral hepatitis is to test 90 percent of the at-risk population and treat 80 percent of people with HBV and HCV by 2030. To some, that may seem like a long time away. To me, this seems just around the corner. When I contracted HCV 30 years ago, the virus didn’t even have its own name yet, let alone a cure. The notion that HCV can be eliminated in my lifetime is a breathtaking goal. It makes me want to roll up my sleeves and get to work.
The best way to get a sense of how WHO is going to do this is to read the Global Hepatitis Report 2017. Here are some successes that show how elimination is possible:
- China, a country with high HBV and HCV infections rates, along with a high incidence of liver disease, has dramatically cut HBV prevalence rate in children under age 5 to less than 1 percent.
- Access to HBV and HCV treatment in Mongolia has dramatically risen; 98 percent of its population has coverage for treatment.
- Egypt, a country where the hepatitis C prevalence rate has been reported as high as 22 percent, has increased access to generic hepatitis C medicines. The price of drugs is dropping. Three months of HCV treatment costs about $200 (USD). In Pakistan, it costs as little as $100 (USD).
- The country of Georgia has a high prevalence of HCV. In 2015, Georgia committed to an elimination plan that included screening and treatment at no cost to those with HCV. Georgia’s goal is to reach HCV elimination by 2020.
- Australia has an ambitious plan to treat all Australians with HCV. It is on track to eliminate hepatitis C by 2026.
- WHO added sofosbuvir plus velpatasvir to its list of essential medicines, which are medications that should be available to everyone, everywhere. The list includes the first combination therapy to treat all six types of hepatitis C.
In 2016, four major global liver organizations issued a joint statement calling for the elimination of viral hepatitis. The organizations are the Latin American Association for the Study of the Liver, the European Association for the Study of the Liver, the Asian Pacific Association for the Study of the Liver, and the American Association for the Study of Liver Disease (AASLD). This year, the National Academies of Sciences, Engineering, and Medicine released their phase two report, “Eliminating the Public Health Problem of Hepatitis B and C in the United States.”
- Eliminating hepatitis requires a little bit of help from everyone, which brings me back to World Hepatitis Day. This year’s theme is “Show Your Face” (#ShowYourFace). Drop by the site, upload your photo, add a message, and put a face on hepatitis.
However, don’t stop there; get involved. Every action, no matter how small or how frequent, puts us a step closer to eliminating viral hepatitis. Click on World Hepatitis Day’s “get involved tab” for suggestions such as:
- Share your Show Your Face message.
- Plan or participate in an event. There are event toolkits on World Hepatitis Day’s web site.
People living with viral hepatitis live with it every day. One awareness day is not enough. But it’s a start. And what I said before, I will say again: Every action, no matter how small or how frequent, puts us a step closer to eliminating viral hepatitis.
American Association for the Study of Liver Disease www.aasld.org
Asian Pacific Association for the Study of the Liver http://apasl.info/
Centers for Disease Control and Prevention www.cdc.gov/hepatitis/hcv/index.htm
European Association for the Study of the Liver www.easl.eu
Latin American Association for the Study of the Liver http://aleh2016.com/wp/
National Academies of Sciences, Engineering, and Medicine: A National Strategy for the Elimination of Hepatitis B and C
WHO Global Hepatitis Report 2017 www.who.int/hepatitis/publications/global-hepatitis-report2017/en
World Health Organization www.who.int/hepatitis/en
World Hepatitis Alliance www.worldhepatitisalliance.org
World Hepatitis Day “Show Your Face” Campaign http://worldhepatitisday.org/showyourface
Lucinda K. Porter, RN, is a long-time contributor to the HCV Advocate and author of “Free from Hepatitis C” and “Hepatitis C One Step at a Time.” She blogs at www.LucindaPorterRN.com and www.Hepmag.com
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