July 28th, In honor of the late Nobel Laureate Baruch Blumberg, who discovered the Hepatitis B virus, the WHO decided in May 2010 to designate World Hepatitis Day to raise awareness of viral hepatitis.
WHO calls on all countries to work together to eliminate viral hepatitis as a public health threat by 2030. The theme of this year’s World Hepatitis Day, “No Waiting to Eliminate Hepatitis,” conveys the urgency of efforts to eliminate hepatitis as a public health threat by 2030.
Globally, 1 Person Dies From Hepatitis Every 30 seconds
Globally, one person dies from a hepatitis-related disease every 30 seconds, even in the current Newcastle pneumonia crisis. Viral hepatitis is one of the leading causes of the global disease burden and an important public health challenge for our country.
There are five main types of hepatitis viruses: type A, type B (HBV), type C (HCV), type D, and type E.
The latest WHO data for 2020 estimates that 325 million people worldwide have viral hepatitis B and C. There are 900,000 deaths per year due to hepatitis B virus infection. Antiviral drugs can cure more than 95% of people infected with hepatitis C. Hepatitis B and C are the most common causes of death, costing 1.1 million lives each year and together resulting in 1.1 million deaths and 3 million new infections each year.
In China, chronic viral hepatitis causes about 380,000 deaths per year, mainly due to cirrhosis and liver cancer caused by hepatitis. In the context of the 2019 coronavirus disease pandemic, viral hepatitis continues to claim thousands of lives every day.
In December 2019, The Lancet subjournal The Lancet Gastroenterology & Hepatology published online a report on the burden of liver disease in the Asia-Pacific region. The report provides an in-depth review of the epidemiology and etiology of liver disease in 11 countries and regions in Asia Pacific and systematically addresses the burden of liver disease in each country and region.
The Asia-Pacific region is home to more than half of the world’s population. According to the WHO Global Burden of Disease report in 2015, 62.6% of global liver disease deaths were from the Asia-Pacific region (1,312,480/2,095,207). Among them, both the burden of liver disease and the main causes of the disease vary among countries. In Asian countries, the median percentage of deaths due to liver disease was 3.9% of total deaths.
In 2015, acute viral hepatitis-related deaths (n=108,276) accounted for 8.2% of the total liver disease-related deaths in Asia Pacific. The leading causes of acute viral hepatitis-related deaths were acute hepatitis B (59.6%) and acute hepatitis E (32.1%), while acute hepatitis A accounted for only 6-3%.
China currently has the largest number of hepatitis B (HBV) infections in the world, and it is estimated that there are currently about 70 million cases of chronic HBV infection in China, including about 20-30 million cases of chronic hepatitis B.
However, through a universal vaccination program for newborns and mandatory HBV/HCV screening of blood products, the prevalence of hepatitis B surface antigen (HBsAg) in China is on a downward trend.
According to a 2015 systematic review, HBsAg prevalence in mainland China decreased from 14.0% in 1957-89 to 5.4% in 1990-2013. The current HBsAg prevalence in China’s general population is 5-6%.
How is Hepatitis Prevented & Treated?
Different viruses cause hepatitis with different routes of transmission and clinical course after infection. Hepatitis A and E are gastrointestinal diseases that can be transmitted through contaminated hands, food or water; hepatitis B, C and D are transmitted mainly through mother-to-child, sexual and blood transfusion.
In mainland China, the main routes of HCV infection include transfusion of contaminated blood products, invasive medical measures and use of injectable drugs. In contrast, since mandatory screening of blood products for HCV, transfusion infections have decreased significantly (in Beijing, the proportion of new infections due to blood transfusion was 84.2% before 1992 and 14.3% after 2004). Viral hepatitis should be detected, diagnosed, isolated, reported, treated and managed early.
Vaccination against hepatitis B is the safest and most effective measure to prevent hepatitis B. Mother-to-child transmission of hepatitis B can be effectively prevented by hepatitis B mother-to-child interruption measures.
China has implemented free hepatitis B vaccination for newborns, and the entire immunization process requires three doses according to the “0, 1, 6 months” immunization program, of which the first dose should be administered as early as possible within 24 hours after birth. Newborns born to hepatitis B virus surface antigen-positive mothers should receive their first dose of hepatitis B vaccine as soon as possible within 24 hours after birth, along with hepatitis B immunoglobulin, and complete subsequent doses according to the hepatitis B vaccine immunization program.
In addition to newborns, adult high-risk groups such as medical personnel, those who have frequent contact with blood and blood products, those who work in childcare institutions, those who receive frequent blood transfusions and blood products, those who are immunocompromised, those whose occupations are prone to trauma, family members of those who are positive for hepatitis B virus surface antigen, men who have sex with men, those who have multiple sexual partners, or those who inject drugs should also receive hepatitis B vaccination.
However, with standardized antiviral treatment, the virus replication can be inhibited to the maximum extent, liver damage can be delayed and reduced, cirrhosis, liver cancer and its complications can be prevented, and quality of life can be improved and life prolonged. Patients should build up confidence, maintain patience, follow medical advice, actively cooperate with treatment, and adhere to regular checkups to ensure the effectiveness of treatment.
Hepatitis A and E
Paying attention to diet, water hygiene and vaccination can effectively prevent hepatitis A and E.
Improve environmental hygiene, strengthen water and fecal management, and improve water supply; develop good personal hygiene habits, wash hands before and after meals, do not eat raw food, and do not drink raw water.
Vaccination can effectively prevent hepatitis A and E. Hepatitis A vaccine has been included in the Expanded National Immunization Program, and free vaccination is given to children 18 months of age. Key populations such as food production and operation workers, childcare institution staff, and people living in groups should also be vaccinated against hepatitis A. Hepatitis E vaccine is available in China and can be administered voluntarily at your own expense.
The majority of hepatitis A and E are acute viral hepatitis, and most patients can recover completely within six months after timely and standardized treatment. A small number of seriously ill patients are at risk of liver failure and should be taken seriously.
There is no vaccine for hepatitis C, but hepatitis C can be prevented by taking effective measures to cut off the transmission route.
Do not share needles or other tattooing and piercing tools, do not share personal items that may cause bleeding, such as razors and toothbrushes; use condoms correctly and avoid unsafe sex; refuse drugs and do not share needles to inject drugs.
stop illegal blood collection and supply. avoid unnecessary injections, blood transfusions and use of blood products. and go to regular medical and health institutions for injections, blood transfusions and use of blood products. The risk of contracting the hepatitis C virus can be significantly reduced.
Hepatitis C can easily become chronic, and most patients can be cured with a full course of standardized antiviral therapy.
Hepatitis D virus can only be contracted simultaneously with or in addition to hepatitis B virus infection. A safe and effective hepatitis B vaccine can provide protection against hepatitis D virus infection.
Patients with viral hepatitis should follow medical advice and standardized treatment, and should not discontinue medication on their own or believe in false advertising. Finally, all patients with viral hepatitis and the general population should avoid alcohol abuse, smoking, irrational use of medication and other behaviors that aggravate liver damage.
It is believed that in the near future, the elimination of hepatitis will be achieved.