On this world hepatitis day in the year 2019, we must be aware of all the most common types of Hepatitis which causes significant morbidity and mortality in the world and especially in developing countries like Pakistan. Fortunately, this is the peak time to create awareness and put emphases on taking strong policy measure to curb disease, as for 2019, Pakistan is the host country for world Hepatitis Day.
As per World Health Organization official website stats, “viral hepatitis B and C affect 325 million people worldwide causing 1.4 million deaths a year. It is the second major killer infectious disease after tuberculosis, and 9 times more people are infected with hepatitis than HIV. Hepatitis is preventable, treatable, and in the case of hepatitis C, curable. However, over 80% of people living with hepatitis are lacking prevention, testing and treatment services.”
In the year 2019, we have seen a large number of Hepatitis A and E patients to an alarmingproportion in Pakistan. While with better technologies and economic growth, hepatitis viruses spread by feco-oral route should have been on the decline, unfortunately, it is exactly the opposite. Therefore, special importance should be given to prevent the spread of these viruses by various preventive measures. If people do get affected by these viruses, they must report to clinicians experienced in treating these viruses and trained in detecting and treating acute liver failure which may occur during these infections.
While on the other hand, the viruses which take the chronic form i.e. Hepatitis B, C and D, causes chronic hepatitis, cirrhosis, its complications and hepatocellular carcinoma, newer medicines have gone a long way to provide highly effective treatment with minimal side effects. Today we have pan-genotypic regimes in Pakistan for Hepatitis C which gives cure rates nearing 99% with excellent safety profile and little or no side effects. Likewise, with Tenofovir Alafenamide introduced in Pakistan, we have added to another list of excellent medicines again with little or no side effects and great tolerability for Hepatitis B.
Still however, great work needs to be done. People must be educated to treat Hepatitis B, C and D before it affects the Liver. Also we have to go a long way to make successful Liver Transplant Centers in Pakistan. We must also educate people to get treatment from medical practitioners for all types of Hepatitis instead of going to quacks, hakims and spiritual healers. At Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC), during screening we found a large number of cancer and non-cancer patients with Hepatitis A and E in almost all of our clinics. It is also alarming there is no demographic distinction in this regards, people even from posh-areas and well economic background are also affected by this disease.To cater this chunk of cancer patients, affected with Hepatitis, at SKMCH&RC we have latest diagnostic and therapeutic facilities. Shaukat Khanum Pathology Laboratory is one of the nation’s largest and most sophisticated facilities that use state-of-the-art equipment for all tests,
On this Hepatitis day, I would emphasize on drinking clean water, consuming hygienic food, proper hand washing techniques, proper sanitation and vaccination against Hepatitis A to prevent Hepatitis A and E along with isolation of patients affected to prevent its spread. For Hepatitis B, C, and D, we must avoid excessive injections, transfusions, venipunctures, dental procedures, cosmetic procedures which involve shared instruments, proper disposal of syringes etc. If they are needed, we must ensure proper sterilization of all used instruments. We must also get vaccination against Hepatitis B.
With it, I conclude with prayers for your healthy and long life. Let us as doctors strive to find the missing millions, and provide them with medical care which is their due right.
The writer is Locum Consultant Gastroenterologist, Shaukat Khanum Hospital