Over 13 million hepatitis patients in Pakistan

Experts stress awareness to control disease; World Hepatitis Day today 

LAHORE

The World Hepatitis Day is marked in Pakistan and around the world on Thursday (today) with a pledge to spread awareness for prevention, control and treatment of this deadly disease. 

On World Hepatitis Day, 28 July 2016, the World Health Organisation (WHO) sets out this year’s theme of “Know hepatitis - Act now", with the objective to sensitise policymakers, health workers and the public know about the infection, know their status by getting tested, and finally seek treatment to reduce needless deaths from this preventable and treatable infection.

Activities such as walks, seminars and free medical camps will take place around the country to improve public knowledge of the risk of hepatitis, and enhance access to hepatitis testing and treatment services to help eliminate hepatitis which is fully preventable and treatable disease.

Viral hepatitis - known as hepatitis A, B, C, D, and E - affects millions of people worldwide, causing acute and chronic liver disease.

Around the world 400 million people are infected with hepatitis B and C, more than 10 times the number of people living with HIV.

Pakistan alone has more than 13 million hepatitis sufferers, many of whom are unaware that they are carriers of the deadly virus. Dr Afzal Bhatti, Associate Professor/Consultant Gastroenterologist, Hepatologist and Liver Transplant Physician, said Pakistan stands 2nd in the world regarding deadly hepatitis prevalence, which has become an epidemic in Pakistan.

The statistics regarding this disease are really alarming as this disease has spread to cities, villages, streets and our homes. Nearly 20 million of Pakistani population is suffering from hepatitis as 1 out of every 10 Pakistanis has contracted hepatitis.

He informed that approximately 150,000 deaths occurred in Pakistan every year. He said that daily 400 patients are dying of this disease as nearly 250,000 patients are adding up per year.

He informed that about 50 pc of the patients remain unaware of this problem until they reach to the last stage where they require liver transplant, which is very costly treatment and still not widely available in our country and is in very initial stage. “So majority of patients have to go abroad for this costly treatment, which adds on to the huge drain of our financial resources,” he added.

He said that, in Pakistan, Hepatitis A and E viruses, causing endemic type of hepatitis, are very common as the main causes of these viruses are polluted food and water. Provision of clean drinking water, hygienic food and improved sanitation can reduce the spread of this type of hepatitis substantially.

An effective vaccine providing lifelong immunity is available for the prevention of HAV infection, though no such vaccine is available for HEV.

He said Hepatitis B & C ratio is 8 to 10 pc and main reasons behind are unnecessary use of syringes, unsafe blood transfusion, usage of unsterile equipments in dental procedures, piercing and other beauty procedures such as pedicure etc.

Usage of used blades in shaving is also a one common reason in rural area. HBV and HCV infections have a potential to turn chronic and cause the fatal complication of cirrhosis of liver if left untreated.

HBV and HCV infections area transmitted by infected blood contaminated needles, surgical instruments and very close contact.

HBV spread can be prevented by mass vaccination with the available preventive vaccine and in case of infected individuals a very effective suppressive therapy is available with a chance of cure as well.

Besides, lack of public awareness on how to prevent against the two diseases, improper sterilisation of medical devices and reusing syringes are other two major reasons behind the massive spread.

He said untreated, patients of Hepatitis B and C can develop liver cirrhosis and hepatocellular carcinoma (HCC), commonly known as liver cancer.

“There is an immense need of spreading awareness regarding this disease prevention and management so that we can prevent this disease or manage this disease at early stage to prevent the loss,” he added. Dr Qayyum Khan, Consultant Gastroenterologist, Shaukat Khanum Memorial Cancer Hospital and Research Centre, while talking in connection with World Hepatitis Day, said that approximately 400 million people worldwide are affected by viral hepatitis infection – over 10 times the number of people infected with HIV. Globally, about 1.4 million people die each year from hepatitis. It is estimated that only 5pc of people with chronic hepatitis know of their infection, and less than 1pc have access to treatment, according to World Health Organization. An estimated 15 million people are infected with the hepatitis B and C virus in Pakistan. The disease is continuously bulging.

He added that hepatitis largely remains unknown as a health threat in much of the world. It is more prevalent particularly in the third world including Pakistan that makes it more alarming. A stringent method should be adopted to address the ‘silent killer’ of viral hepatitis, he said.

Viral hepatitis is also the leading cause of liver cancer. Liver cancer is the second biggest cancer killer and symptoms of viral hepatitis often go unnoticed. Therefore anyone who might think they may have been exposed should get tested, said Dr Qayyum.

Viral hepatitis can be avoided. The known risks are unprotected sexual contact with an infected person with hepatitis B or C, sharing infected needles amongst drug users, and infected razors used in orthodox hair salons. Tainted blood and dirty needles of any kind can transmit these infections via blood into one’s body.

When asked, he said viral hepatitis is treatable. Everybody deserves the chance to find out that if they have hepatitis B or C. Most probably treatment would be their option and in most cases something can be done to halt or control the infection. He suggested to get vaccinated yourself and your children for hepatitis B.

He said that there is no place for stigmatising people with hepatitis B and C. They cannot transmit the infection with casual contact like shaking hands and we must all play our part in fighting the parallel social stigmatisation and discrimination against people with these infections so that there are no obstacles in the support they need in an effort to educate about, prevent and treat this huge epidemic, Dr Qayyum Khan concluded.

It may be noted that this year World Health Organisation is observing World Hepatitis Day with the slogan “Know Hepatitis – Act Now” with the vision of eliminating hepatitis as a public health threat by 2030 can be achieved, if people and countries affected by this disease are better equipped and enabled to "know hepatitis" and "act now".

Dr Israr-ul-Haq Toor, Associate Professor of Gastroenterology, Post Graduate Medical Institute and Lahore General Hospital, while talking on the eve of World Hepatitis Day, said that lack of awareness among masses about hepatitis is a major cause of large scale rampancy of this disease and those who are sensitised about this disease to some extent generally do not take it seriously in the beginning. They get worried only when this disease goes out of control and their liver stops function. 

Dr Toor said that in the past, medical science was aware about only two types of this ailment, Hepatitis A and B. Now more dangerous types of this disease D, E and G have been recovered. Hepatitis B, C and D are more dangerous but they cannot harm without their combination with Hepatitis B.

Dr Toor told that Hepatitis C can be shifted to other persons through blood infusion, used syringes, tattoos on body, drugs, sexual interaction with many men or women, dental diseases and use of infected operates during surgery. He said that hepatitis do not spread by touching the patients. We should encourage such patients convincing them that timely treatment is very necessary to survive.

Mir Khalil-ur-Rahman Memorial Society (Jang Group of Newspapers) will organise a “Hepatitis Awareness Seminar on Thursday (today) at a local hotel at 2:30 pm. Besides, Lahore Press Club has also arranged a Hepatitis Screening Camp and Awareness Seminar today from 12 noon to 4 pm.