World Hepatitis Day, 2021

1. WORLD HEPATITIS
DAY
Presented By:
Dr. Hirdesh Chawla
ADMO, Delhi Division
Northern Railways

2.  World Hepatitis Day is observed each year on 28 July
to raise awareness of viral hepatitis, an inflammation of
the liver that causes severe liver disease and
hepatocellular cancer. This year’s theme is “Hepatitis
can’t wait”, conveying the urgency of efforts needed to
eliminate hepatitis as a public health threat by 2030.
With a person dying every 30 seconds from a hepatitis
related illness – even in the current COVID-19 crisis –
we can’t wait to act on viral hepatitis.

3.  Every year 28th July is celebrated as World Hepatitis
Day because it is the birthday of Noble Prize winning
scientist Dr. Baruch Blumberg who discovered Hepatitis
B virus and developed vaccine and diagnostic tools for
it.

4.  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.

5. Messages for the public:
 People living with hepatitis can’t wait for life saving treatments.
 Hepatitis B testing and treatment for pregnant women can’t wait. We
can prevent transmission from mothers to their babies
 Newborn babies can’t wait for their hepatitis B vaccination at birth
 People affected by hepatitis can’t wait to be protected against stigma
and discrimination.
 Community organisations can’t wait for greater investment.
 Decision makers can’t wait and must act now to make hepatitis
elimination a reality through political will and funding.

6. Messages for policy makers:
 Integration of viral hepatitis elimination with other health
services can’t wait.
 Funding hepatitis care can’t wait.
 Triple elimination of mother-to-child-transmission of HIV,
hepatitis B and syphilis can’t wait.
 Validating hepatitis elimination efforts in countries can’t wait.
 Universal health coverage for all people with hepatitis can’t
wait. Starting now means saving lives.

7. Messages for National
leaders:
 Setting national hepatitis elimination targets can’t wait. A
world without viral hepatitis by 2030 starts with your country.
 Caring for the most vulnerable people with hepatitis can’t
wait. Be it young children or people who inject drugs, some
people are more exposed and at risk – their lives matter.
 Scaling up of essential hepatitis services can’t wait.
 Engaging communities in hepatitis services can’t wait.
 Decision makers can’t wait and must act now to make
hepatitis elimination a reality through political will and
funding.

8. HEPATITIS A
 Hepatitis A is a viral liver disease that can cause mild to severe illness.
 The hepatitis A virus (HAV) is transmitted through ingestion of contaminated food and water or
through direct contact with an infectious person. The virus is primarily spread when an
uninfected (and unvaccinated) person ingests food or water that is contaminated with the
faeces of an infected person. The disease is closely associated with unsafe water or food,
inadequate sanitation, poor personal hygiene and oral-anal sex.
 Almost everyone recovers fully from hepatitis A with a lifelong immunity. However, a very small
proportion of people infected with hepatitis A could die from fulminant hepatitis.
 The risk of hepatitis A infection is associated with a lack of safe water, and poor sanitation and
hygiene.
 In countries where the risk of infection from food or water is low, there are outbreaks among
men who have sex with men (MSM) and persons who inject drugs (PWIDs).
 A safe and effective vaccine is available to prevent hepatitis A.
 The incubation period of hepatitis A is usually 14–28 days.

9. HEPATITIS B
 Hepatitis B is a viral infection that attacks the liver and can cause both acute and
chronic disease.
 The virus is most commonly transmitted from mother to child during birth and
delivery, as well as through contact with blood or other body fluids. Hepatitis B is
also spread by needlestick injury, tattooing, piercing and exposure to infected blood
and body fluids, such as saliva and menstrual, vaginal and seminal fluids.
Transmission of the virus may also occur through the reuse of contaminated
needles and syringes or sharp objects either in health care settings, in the
community or among persons who inject drugs. Sexual transmission is more
prevalent in unvaccinated persons with multiple sexual partners.
 WHO estimates that in 2015, 257 million people were living with chronic hepatitis B
infection (defined as hepatitis B surface antigen positive).
 In 2015, hepatitis B resulted in an estimated 887 000 deaths, mostly from cirrhosis
and hepatocellular carcinoma (i.e. primary liver cancer).

10.  As of 2016, 27 million people (10.5% of all people
estimated to be living with hepatitis B) were aware of
their infection, while 4.5 million (16.7%) of the people
diagnosed were on treatment.
 Hepatitis B is a viral infection that attacks the liver and
can cause both acute and chronic disease.
 A safe and effective vaccine that offers 98% to 100%
protection against hepatitis B is available. Preventing
hepatitis B infection averts the development of
complications including chronic disease and liver
cancer.

15. HEPATITIS C
 Hepatitis C is a liver disease caused by the hepatitis C virus
(HCV): the virus can cause both acute and chronic hepatitis,
ranging in severity from a mild illness lasting a few weeks to a
serious, lifelong illness.
 Hepatitis C is a major cause of liver cancer.
 The hepatitis C virus is a bloodborne virus: the most common
modes of infection are through exposure to small quantities of
blood. This may happen through injection drug use, unsafe
injection practices, unsafe health care, transfusion of unscreened
blood and blood products, and sexual practices that lead to
exposure to blood.
 Globally, an estimated 71 million people have chronic hepatitis C
virus infection.

16.  A significant number of those who are chronically infected
will develop cirrhosis or liver cancer.
 WHO estimated that in 2016, approximately 399 000 people
died from hepatitis C, mostly from cirrhosis and
hepatocellular carcinoma (primary liver cancer).
 Antiviral medicines can cure more than 95% of persons with
hepatitis C infection, thereby reducing the risk of death from
cirrhosis and liver cancer, but access to diagnosis and
treatment is low.
 There is currently no effective vaccine against hepatitis C;
however, research in this area is ongoing.

19.  HCV genotype 1 is the most prevalent worldwide
(49.1%), followed by genotype 3 (17.9%), 4 (16.8%)
and 2 (11.0%). Genotypes 5 and 6 are responsible for
the remaining < 5%.
 HCV genotype 3 is predominant in India

21. HEPATITIS D
 Hepatitis D virus (HDV) is a virus that requires hepatitis B virus
(HBV) for its replication. HDV infection occurs only simultaneously
or as super-infection with HBV.
 The virus is most commonly transmitted from mother to child
during birth and delivery, as well as through contact with blood or
other body fluids.
 At least 5% of people with chronic HBV infection are co-infected
with HDV, resulting in a total of 15 – 20 million persons infected
with HDV worldwide. However, this is a broad global estimation
since many countries do not report the prevalence of HDV.
 Worldwide, the overall number of HDV infection has decreased
since 1980s. This trend is mainly due to a successful global HBV
vaccination programme.

22.  HDV-HBV co-infection is considered the most severe
form of chronic viral hepatitis due to more rapid
progression towards liver-related death and
hepatocellular carcinoma.
 Currently, treatment success rates are generally low.
 Hepatitis D infection can be prevented by hepatitis B
immunization.

23. HEPATITIS E
 Hepatitis E is a liver disease caused by infection with a virus known as
hepatitis E virus (HEV).
 Every year, there are an estimated 20 million HEV infections worldwide,
leading to an estimated 3.3 million symptomatic cases of hepatitis E.
 WHO estimates that hepatitis E caused approximately 44 000 deaths in
2015 (accounting for 3.3% of the mortality due to viral hepatitis).
 The virus is transmitted via the fecal-oral route, principally via
contaminated water.
 Hepatitis E is found worldwide, but the disease is most common in East
and South Asia.
 A vaccine to prevent hepatitis E virus infection has been developed and is
licensed in China, but is not yet available elsewhere.

24. HEPATITIS G
Hepatitis G virus (HGV) is a rare cause of hepatic inflammation. Although chronic infection and
viremia have been documented, histologic evidence is rare, and serum aminotransferase levels are
usually normal.
HGV is a single-stranded RNA virus classified in the Flaviviridae family; the virus shares 27 percent
homology with hepatitis C virus (HCV).
The liver is not a significant site of replicatition
Most infected persons are asymptomatic.
HGV can cause chronic infection and viremia; however, there is no conclusive evidence to indicate
that HGV causes fulminant or chronic liver disease.
Co-infection with hepatitis B virus (HBV) or HCV does not seem to worsen the course or severity of
disease.
 Transmission- Blood and sexual contact,T ransplacental, rarely
 Risk Groups- Transfusion and organ transplant recipients, Injection drug users, Hemodialysis
patients, Men who have sex with men