July 28th World Hepatitis Day —“I Can’t Wait”
World Hepatitis Day (WHD) takes place every year on July 28th, bringing the world together under a theme to raise awareness of the global burden of hepatitis and to influence real change. The theme for WHD is “I Can’t Wait” because preventing and treating hepatitis can’t wait.
WHD is observed annually on July 28th, the birthday of Dr. Baruch Blumberg (1925-2011). Dr. Blumberg discovered the hepatitis B virus (HBV) virus in 1967 and then two years later developed the first HBV vaccine and won the Nobel Prize for those achievements.
WHD is coming at an interesting time as the world is currently facing a new outbreak of unexplained acute hepatitis infections affecting children. The World Health Organization, (WHO) together with scientists and policymakers in affected countries, are working to understand the cause of this infection that does not appear to belong to any of the known five types of hepatitis viruses.
Types of Hepatitis—Know Your ABCs
Hepatitis A (HAV)
- Can cause mild to severe illness.
- Virus is transmitted through ingestion of contaminated food and water or direct contact with an infectious person.
- Almost everyone recovers fully from HAV with lifelong immunity.
- A vaccine is available to prevent HAV.
Hepatitis B (HBV)
- Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic diseases.
- The virus is most commonly transmitted from mother to child during birth, as well as through contact with blood or other body fluids during sex with an infected partner, unsafe injections, or exposure to sharp instruments.
- HBV can be prevented by vaccines that are safe, available, and effective.
Hepatitis C (HVC)
- The virus can cause both acute and chronic hepatitis.
- Most infections occur through exposure to blood from unsafe injection practices, unsafe health care, unscreened blood transfusions, injection drug use, and sexual practices that lead to exposure to blood.
- Antiviral medicines can cure more than 95% of persons with HCV infection, but access to diagnosis and treatment is low.
- There is currently no effective vaccine against HCV.
Hepatitis D (HBD)
- HDV infection occurs when people become infected with both HBV and D simultaneously.
- More likely to occur among indigenous populations, recipients of hemodialysis, and people who inject drugs.
- Worldwide, the number of infections has decreased since the 1980s, due mainly to a successful global HBV vaccination program.
- The combination of HDV and HBV infection is considered the most severe form of chronic viral hepatitis due to more rapid progression towards liver-related death and hepatocellular carcinoma.
- Hepatitis D infection can be prevented by HBV immunization, but treatment success rates are low.
- The virus is transmitted via the fecal-oral route, principally via contaminated water.
- Hepatitis E is found worldwide, but the disease is most common in East and South Asia.
- A vaccine has been developed and is licensed in China but is not yet available elsewhere.
The World Health Organization (WHO) estimates that during 2019:
- 296 million people worldwide were living with hepatitis B
- 58 million people worldwide were living with HCV
- 1.5 million people were newly infected with chronic HBV
- 1.5 million people were newly infected with chronic HCV
- There were an estimated 3.2 million adolescents and children with chronic HCV infection.
According to the US Department of Health and Human Services;
- 2.4 million people are estimated to be living with HCV in the United States. The actual number may be as high as 4.7 million or as low as 2.5 million.
- 850,000 people in the US are estimated to be living with HBV. The actual number may be as high as 2.2 million or as low as 730,000.
- More than half of persons living with hepatitis do not know they have the virus. Thus, they are at risk for life-threatening liver disease and cancer and unknowingly transmitting the virus to others.
- Asian Americans and Pacific Islanders are the racial/ethnic groups most heavily affected by the HBV virus.
WHO aims to achieve hepatitis elimination by 2030. To get there, WHO calls on countries to achieve specific targets:
- Reduce new infections of HBV and C by 90%
- Reduce hepatitis-related deaths from liver cirrhosis and cancer by 65%;
- Ensure that at least 90% of people with HBV and C virus are diagnosed; and
- At least 80% of those eligible receive appropriate treatment.
- Universal HBV immunization of infants: reach 90% coverage
Low coverage of the testing and treatment is the most important gap to address to achieve the global elimination goals by 2030.