World Hepatitis Day: a new era for hepatitis control

[Guest guest]

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960839-8/fu\

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The Lancet, Volume 378, Issue 9791, Pages 552 - 553, 13 August 2011

doi:10.1016/S0140-6736(11)60839-8Cite or Link Using DOI

Published Online: 28 July 2011

World Hepatitis Day: a new era for hepatitis control

W Ward a b, Francisco M Averhoff a b, K Koh b

In recognition of a public health issue that affects more than half a billion

people worldwide,1 the World Health Assembly has designated July 28 as World

Hepatitis Day.2 Every year, this day will challenge the world to meet the urgent

need for prevention and control of viral hepatitis and to ensure the best

possible care and treatment for those infected. July 28 coincides with the

birthday of Baruch Blumberg (1925—2011), who not only discovered the hepatitis B

virus (HBV) in 1967 and developed the first hepatitis B vaccine in 1969, but

also won the Nobel Prize in Physiology or Medicine in 1976 for these

achievements.3 Much progress has since been made, and hepatitis B vaccination is

now the most effective tool for preventing viral hepatitis and liver cancer.

Vaccines can also prevent hepatitis A, and hepatitis E vaccines show promise in

clinical trials.1, 4

Screening of donated blood for HBV and hepatitis C virus (HCV) has substantially

lowered the number of viral hepatitis infections caused by transfusions.

Provision and proper disposal of medical equipment can reduce transmission of

HBV and HCV in health-care settings.1 With diagnostic assessment, patients can

readily learn their infection status and, if infected, can access care

services—for example, a rapid test for HCV antibody is now available in Europe

and the USA.5 Antiviral therapies for people with HBV and HCV can reduce or

eliminate viral replication, decreasing development of associated liver

cirrhosis and liver cancer.1, 6 The potential for the combined global impact of

these tools is tantalising. For example, for the past 11 years the GAVI Alliance

has been committed to supporting the introduction of paediatric hepatitis B

vaccination in 67 countries7 and, in 2009, about 70% of infants worldwide

received the three-dose series of hepatitis B vaccine.8 Furthermore, the US

Department of Health and Human Services has unveiled an action plan for the

first comprehensive federal response to viral hepatitis.9 Such developments

raise hope for a new era of hepatitis control.

Unfortunately, inadequate capacity to deliver effective interventions

compromises outcomes everywhere, irrespective of a country's level of available

resources. For example, only about one in five infants worldwide receives a

birth dose of hepatitis B vaccine, which is necessary to prevent perinatal

transmission of HBV.10 Additionally, many adults in the USA at risk for

hepatitis B remain unvaccinated, including 58% of adults at risk for hepatitis

B.9, 11 Inadequate screening of donated blood in many countries might result in

up to 80 000 HBV infections and 500 000 HCV infections annually.12 Suboptimum

infection control continues to threaten lives—sharps injuries place health-care

workers and patients at risk for viral hepatitis, and unsafe injections can

cause as many as 20 million HBV and 2 million HCV infections every year.13 Drug

use and other high-risk behaviours result in HIV and viral hepatitis

co-infections.9 Although new antiviral drugs create opportunities for reducing

the morbidity and mortality from HBV and HCV,1, 6 their public health impact

depends on awareness and access to care and treatment. In the USA, up to 75% of

people are unaware of their infection status, and few of those who are aware

receive appropriate care and treatment.9, 11 Barriers to testing, care, and

treatment include health-care costs, insufficient training of providers,

restricted public health capacity for surveillance and testing, and low

community awareness. These barriers are magnified in resource-constrained

settings.

World Hepatitis Day confronts the worldwide gap between the promise and the

reality of hepatitis control. The main priority is the recognition that,

worldwide, about 500 million people (one in 12 individuals) are living with

viral hepatitis, of whom 1 million will die every year.1, 2 Control of viral

hepatitis receives only a fraction of the attention and resources that are

dedicated to other major public health threats with similar or lesser morbidity

and mortality.11 Hence immediate action is necessary to raise awareness, build

collaborations to implement interventions that are appropriate for

epidemiological patterns, and motivate policy makers to support better systems

of prevention, care, and treatment of viral hepatitis. The level of suffering

from viral hepatitis is unacceptable. July 28 represents a call to action that

can catalyse commitment worldwide. Public health leaders, policy makers,

non-governmental organisations, and others must join together to confront and

combat this silent epidemic. World Hepatitis Day should celebrate forward

progress and rejection of the status quo.

We declare that we have no conflicts of interest.

References<cut>

[Guest guest]

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960839-8/fu\

lltext?elsca1=ETOC-LANCET & elsca2=email & elsca3=segment

The Lancet, Volume 378, Issue 9791, Pages 552 - 553, 13 August 2011

doi:10.1016/S0140-6736(11)60839-8Cite or Link Using DOI

Published Online: 28 July 2011

World Hepatitis Day: a new era for hepatitis control

W Ward a b, Francisco M Averhoff a b, K Koh b

In recognition of a public health issue that affects more than half a billion

people worldwide,1 the World Health Assembly has designated July 28 as World

Hepatitis Day.2 Every year, this day will challenge the world to meet the urgent

need for prevention and control of viral hepatitis and to ensure the best

possible care and treatment for those infected. July 28 coincides with the

birthday of Baruch Blumberg (1925—2011), who not only discovered the hepatitis B

virus (HBV) in 1967 and developed the first hepatitis B vaccine in 1969, but

also won the Nobel Prize in Physiology or Medicine in 1976 for these

achievements.3 Much progress has since been made, and hepatitis B vaccination is

now the most effective tool for preventing viral hepatitis and liver cancer.

Vaccines can also prevent hepatitis A, and hepatitis E vaccines show promise in

clinical trials.1, 4

Screening of donated blood for HBV and hepatitis C virus (HCV) has substantially

lowered the number of viral hepatitis infections caused by transfusions.

Provision and proper disposal of medical equipment can reduce transmission of

HBV and HCV in health-care settings.1 With diagnostic assessment, patients can

readily learn their infection status and, if infected, can access care

services—for example, a rapid test for HCV antibody is now available in Europe

and the USA.5 Antiviral therapies for people with HBV and HCV can reduce or

eliminate viral replication, decreasing development of associated liver

cirrhosis and liver cancer.1, 6 The potential for the combined global impact of

these tools is tantalising. For example, for the past 11 years the GAVI Alliance

has been committed to supporting the introduction of paediatric hepatitis B

vaccination in 67 countries7 and, in 2009, about 70% of infants worldwide

received the three-dose series of hepatitis B vaccine.8 Furthermore, the US

Department of Health and Human Services has unveiled an action plan for the

first comprehensive federal response to viral hepatitis.9 Such developments

raise hope for a new era of hepatitis control.

Unfortunately, inadequate capacity to deliver effective interventions

compromises outcomes everywhere, irrespective of a country's level of available

resources. For example, only about one in five infants worldwide receives a

birth dose of hepatitis B vaccine, which is necessary to prevent perinatal

transmission of HBV.10 Additionally, many adults in the USA at risk for

hepatitis B remain unvaccinated, including 58% of adults at risk for hepatitis

B.9, 11 Inadequate screening of donated blood in many countries might result in

up to 80 000 HBV infections and 500 000 HCV infections annually.12 Suboptimum

infection control continues to threaten lives—sharps injuries place health-care

workers and patients at risk for viral hepatitis, and unsafe injections can

cause as many as 20 million HBV and 2 million HCV infections every year.13 Drug

use and other high-risk behaviours result in HIV and viral hepatitis

co-infections.9 Although new antiviral drugs create opportunities for reducing

the morbidity and mortality from HBV and HCV,1, 6 their public health impact

depends on awareness and access to care and treatment. In the USA, up to 75% of

people are unaware of their infection status, and few of those who are aware

receive appropriate care and treatment.9, 11 Barriers to testing, care, and

treatment include health-care costs, insufficient training of providers,

restricted public health capacity for surveillance and testing, and low

community awareness. These barriers are magnified in resource-constrained

settings.

World Hepatitis Day confronts the worldwide gap between the promise and the

reality of hepatitis control. The main priority is the recognition that,

worldwide, about 500 million people (one in 12 individuals) are living with

viral hepatitis, of whom 1 million will die every year.1, 2 Control of viral

hepatitis receives only a fraction of the attention and resources that are

dedicated to other major public health threats with similar or lesser morbidity

and mortality.11 Hence immediate action is necessary to raise awareness, build

collaborations to implement interventions that are appropriate for

epidemiological patterns, and motivate policy makers to support better systems

of prevention, care, and treatment of viral hepatitis. The level of suffering

from viral hepatitis is unacceptable. July 28 represents a call to action that

can catalyse commitment worldwide. Public health leaders, policy makers,

non-governmental organisations, and others must join together to confront and

combat this silent epidemic. World Hepatitis Day should celebrate forward

progress and rejection of the status quo.

We declare that we have no conflicts of interest.

References<cut>