Viral hepatitis
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There are five main types of viral hepatitis: A, B, C, D, and E. Hepatitis B and C often cause chronic infections that can lead to cirrhosis and liver cancer, resulting in approximately 1 million deaths annually worldwide. An estimated 2 billion people have been infected with hepatitis B virus and 150 million are chronically infected with hepatitis C virus. Transmission of hepatitis B and C occurs primarily through contact with contaminated blood or body fluids. The WHO is working to increase prevention, testing, treatment and policy efforts to address the growing burden of viral hepatitis globally.
Viral hepatitis
- 2. What is hepatitis? • Hepatitis is a viral infection that causes inflammation of the liver • There are five main types of viral hepatitis: A, B, C, D, E • Hepatitis A and E are typically caused by ingestion of contaminated food or water • Hepatitis B, C and D are typically caused by contact with contaminated blood or body fluids • In particular viral hepatitis types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer • About 1 million people die each year from causes related to viral hepatitis Sources: WHO. Global Alert and Response. Hepatitis. www.who.int/crs/disease/hepatitis
- 3. Global burden of hepatitis B and C • The global burden of disease due to acute hepatitis B and C, and cancer and cirrhosis of the liver, accounts for about 2.7% of all deaths. This is expected to increase further in the next two decades • An estimated 57% of liver cirrhosis and 78% of primary liver cancer are due to hepatitis B virus (HBV) or hepatitis C virus (HCV) infection • In total, about 2 billion people have been infected with HBV; about 600 000 people die each year due to the consequences of hepatitis B • About 150 million people are chronically infected with HCV (about 10 times higher than HIV estimates); more than 350 000 people die each year from hepatitis C-related liver diseases Sources: WHO (2013). Media Centre. Hepatitis C Fact Sheet No 164. Updated July 2013; WHO (2013) Media Centre. Hepatitis B Fact sheet No 204. Updated July 2013. WHO (2013). Immunization, Vaccines and Biologicals. Hepatitis.
- 4. Hepatitis B and C in the WHO European Region • Hepatitis B and C cause a high burden of disease in the WHO European Region, especially among key populations • Only 1 in 5 persons exposed to the hepatitis B and C virus develops acute symptoms, but chronic infection is common • Hepatitis B and C each is estimated to affect up to 2% of the population in the Region (13.3 million people living with chronic hepatitis B, 15 million with chronic hepatitis C); together, they cause over 120 000 deaths per year • Two-thirds of infected persons live in eastern Europe and central Asia • Co-infection of HCV and HIV is common, especially among people who inject drugs Hope VD et al. (2013). Prevalence and estimation of hepatitis B and C infections in the WHO European Region: a review of data focusing on the countries outside the European Union and the European Free Trade Association WHO Regional Office for Europe. Hepatitis. www.euro.who.int/hepatitis
- 5. Main transmission modes for hepatitis B, C virus • Hepatitis B virus (HBV): • Sexual contact • Mother-to-child transmission • Blood-to-blood contact by unsafe injecting practices, blood transfusion, unsterile medical equipment (HBV is a an important occupational hazard for health workers) • Hepatitis C virus (HCV): • Blood-to-blood contact by unsafe injecting practices (main transmission mode in the WHO European Region), blood transfusion, unsterile medical equipment • Sexual contact (less common) HBV and HCV are many more times infective than HIV Sources: WHO (2013). Media Centre. Hepatitis C Fact Sheet No 164. Updated July 2013; WHO (2013) Media Centre. Hepatitis B Fact sheet No 204. Updated July 2013
- 6. Main prevention measures for hepatitis B and C • Promote vaccination against hepatitis B • Ensure needle and syringe programmes to avoid sharing injecting equipment • Promote safe sex • Ensure adequately sterilized medical equipment • Promote hepatitis B and C testing and counselling services • Raise awareness for the diseases and their transmission modes, especially among key populations
- 7. Treatment of hepatitis B and C • Usually, acute infection with hepatitis B or C does not require treatment • Combination antiviral therapy has been the mainstay of treatment for chronic hepatitis B and C • Treatment remains poorly accessible and too costly for many of those in need. Also, poor response to the treatment, problems with adherence, and intolerance to the medicines result in low numbers of people on treatment • New and effective medications are becoming available Sources: WHO (2013). Media Centre. Hepatitis C Fact Sheet No 164. Updated July 2013; WHO (2013) Media Centre. Hepatitis B Fact sheet No 204. Updated July 2013
- 8. WHO response to the epidemic • In 2010, Resolution WHA63.18 was adopted at the World Health Assembly, calling for a comprehensive approach to the prevention and control of viral hepatitis • Recent publications: • Guidance on prevention of viral hepatitis B and C among people who inject drugs (2012) • Prevention & Control of Viral Hepatitis Infection: Framework for Global Action (2012) • Publication being launched on World Hepatitis Day: • Global Hepatitis Policy Report (2013) • Upcoming publications (expected in 2014): • Guidance on the surveillance of hepatitis B and C • Guidance on the treatment of Hepatitis C Sources: WHO. Global Alert and Response. Hepatitis. www.who.int/crs/disease/hepatitis
- 9. 28 July 2013 To increase awareness and understanding of viral hepatitis and the diseases that it causes
- 10. WHO Regional Office for Europe HIV/AIDS, STIs and Viral Hepatitis Programme www.euro.who.int/hepatitis