Eradication of viral hepatitis, which still remains a major public health problem, is possible by 2080 if a dedicated trained public health cadre, a mechanism to provide free drugs to patients of viral hepatisis in the lines of the National AIDS Control Organisation (NACO), is ensured, health experts have said.
In an editorial published in the Health Ministry's reputed medical journal, Indian Council of Medical Journal (ICMR), experts Manoj Kumar and Shiv K Sarin from Department of Hepatology, Institute of liver and Biliary Sciences, Delhi have also stressed on ensuring safe drinking water and sanitation as well as safe injection and blood safety to tackle the disease in the country.
“There is a need for National Viral hepatitis Prevention and Management Strategy with focus on various aspects of viral hepatitis prevention and management,” the experts said as they noted that India has “intermediate to high endemicity” for hepatitis B surface antigen (HBs Ag) and an estimated 40 million chronic HBV infected people.
It constitutes approximately 11 per cent of the estimated global burden. Population prevalence of chronic HBV infection in India is around 3-4 per cent.
Outbreaks of acute and fulminant hepatitis B still occur mainly due to improperly sterilised needles and syringes, as demonstrated by the recent outbreak of acute hepatitis B in Modasa Town of Gujarat, said the experts.
“Prevalence of hepatitis C has been observed to be relatively higher in Punjab, Haryana, Andhra Pradesh, Puducherry, Arunachal Pradesh and Mizoram compared to other States. HAV and HEV are important causes of acute viral hepatitis and acute liver failure in India," says the editorial.
HAV infection is responsible for 10-30 per cent of acute viral hepatitis and 5-15 per cent of acute liver failure (AlF) cases in India.
HEV infection is responsible for 10-40 per cent of acute hepatitis and 15-45 per cent of AlF in India13. Acute HEV has inordinately high mortality rate of 15 to 25 per cent in pregnant women in the third trimester, as per the article.
“Blood safety is a challenge in India because of the high prevalence of HIV, HCV, and HBV, the relatively and the lack of standardisation of screening procedures among the multitude of blood collection centres,” say the experts adding that centralised NAT screening centres can help in improving the safety of blood supply in our country.