KARACHI: “All hepatitis viruses are common in Pakistan. Hepatitis refers to an inflammatory condition of the liver. Pakistan has been ranked second in the world in terms of having the highest prevalence of Hepatitis C Virus. Pakistan has the highest therapeutic use of injections worldwide. Overall 15 million people are affected by Hepatitis B & C viruses in the country. Following the prevalence of the diseases, there is an alarming situation in Sindh.”
“Transmission of Hepatitis E has also been linked with monsoon rains. The country needs to take effective measures to maintain its pace with the rest of the world to achieve the goal of eliminating hepatitis by 2030. Hepatitis B & C are life-threatening ailments. Citizens are required to be informed about the fatality of the diseases.”
Prof Dr Wasim, Associate Dean and Chairman, Department of Professional Education, Hepatologist, and Consultant Gastroenterologist, at Aga Khan University Hospital, expressed these views at the 51st Public Awareness Seminar on “Strategies for Eliminating Viral Hepatitis from Pakistan,” held at the Dr Panjwani Center for Molecular Medicine and Drug Research (PCMD) at the University of Karachi.
The Dr Panjwani Center and Virtual Education Project Pakistan (VEPP) jointly organized the seminar to observe World Hepatitis Day 2019.
It is pertinent to mention here that the WHO’s global hepatitis strategy, endorsed by all WHO Member States, aims to reduce new hepatitis infections by 90% and deaths by 65% between 2016 and 2030.
Prof Jafri said that hepatitis was a major global health problem. Pakistan owns all five main types of viral hepatitis A, B, C, D, and E, which shows the country is endemic to hepatitis, he said.
The poor law and order situation and illiteracy in the country forced our authorities to depute an army soldier along with health workers so that two or three drops of anti-polio vaccines could be administered to vulnerable kids, he lamented.
Symptoms of a liver problem can include jaundice abdominal pain, loss of appetite, nausea, vomiting, diarrhea, and fever, he said. As per the Global Burden of Disease Study 2010 and 2013, annually, hepatitis viral caused more deaths worldwide than other diseases like HIV/AIDS, tuberculosis, malaria, etc.
Hepatitis E is common in Pakistan, China, and other parts of the world, he said, adding that transmission of Hepatitis E is also linked with monsoon rains.
He added that HCV was curable if the patient was diagnosed timely. Hepatitis C is a bloodborne virus and a significant cause of liver cancer.
He further stated that there is no vaccine available for HCV, while safe, available, and effective vaccines can prevent Hepatitis B.
Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. This infection is not curable but treatable, he said.
Prof Jafri said that hepatitis A and E viruses mainly caused jaundice, which is one of the outcomes of inflammation of the liver.
“Hepatitis can be caused by drugs, alcohol or other toxins, by infection with bacteria, viruses or parasites, and hosts of other causes including storage disorders. Viruses and alcohol, however, are the most common cause of the illness, he said.
He pointed out that B and C were transmitted through exposure to infective blood. He maintained that HBV could be transmitted from infected mothers to infants at the time of birth. Transmission may also occur through transfusions of HBV and HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use.
Both the viruses also pose a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-hepatitis patients, he said.
He lamented that Pakistan had the highest therapeutic use of injection worldwide; adding that the higher was the injection using the higher was chance of bloodborne infections.
“Sexual transmission is one of the other causes,” said Prof Jafri.
He noted that viral hepatitis sometimes goes away without any treatment, but in some cases, the virus stays in the body and causes a chronic infection.
He said that treatment could be successful with an appropriate patient selection and timely diagnosis. He pointed out that there were some essential goals to eliminate HCV.
There is a need to prevent squeal of advancing liver disease in those already infected.
Pakistan needs powerful political commitment for the elimination of HCV in the country, he said, adding that expand screening program was fundamental for any country to get control over the spread of the infection.