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Table of Contents   
EDITORIAL COMMENTARY  
Year : 2017  |  Volume : 10  |  Issue : 5  |  Page : 1101-1102
Necessity to strengthen prevention activities and expand treatment services to accomplish global elimination of Hepatitis C


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

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Date of Web Publication6-Nov-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Necessity to strengthen prevention activities and expand treatment services to accomplish global elimination of Hepatitis C. Ann Trop Med Public Health 2017;10:1101-2

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Necessity to strengthen prevention activities and expand treatment services to accomplish global elimination of Hepatitis C. Ann Trop Med Public Health [serial online] 2017 [cited 2017 Nov 20];10:1101-2. Available from: http://www.atmph.org/text.asp?2017/10/5/1101/217529


Dear Editor,

Hepatitis C is a viral infection of the liver observed worldwide with highest prevalence being observed in Africa and Asia.[1] The disease can manifest either as acute (mild illness lasting for a few weeks) or as a chronic form (serious lifelong illness).[2] The current global estimates suggest that almost 130-150 million people have the chronic infection; while every year 0.7 million people lose their lives to the complications associated with the disease.[1]

Infact, a significant proportion of these chronic cases eventually land up into cirrhosis or as liver malignancy.[2] These complications not only cast a significant financial burden on the households (direct and indirect costs), society and the health system, but even accounts for a massive impairment on the quality of life of people.[3],[4]

The causative virus is a blood-borne virus and is predominantly transmitted through unsafe injection practices, poor sterilization of medical equipments, and due to the defective practice of comprehensive screening of blood and blood products for the transfusion-transmissible infections.[2],[5] It is quite difficult to diagnose the disease during its acute stage due to the asymptomatic nature, and often the diagnosis is established by serological tests like a demonstration of antibodies (for screening) and detection of viral ribonucleic acid (for confirmation).[1] However, it has been recommended to screen high-risk group of people to prevent further transmission of the disease.[1],[2] Further, people diagnosed with the chronic infection should be subjected to the liver biopsy to assess extent of liver damage, and identification of the genotypic strain to improve the treatment prospects.[1]

It is very vital to understand that not all the patients require treatment as the immune response in some proportion of patients will clear the infection.[1] Also, the currently available medications are quite effective and the disease can be cured in 9 out of 10 patients. Nevertheless, the cure rate is determined by multiple factors like time of diagnosis, strain of the virus, involved cost, provision of the standardized therapy, and access of the people to all the services.[1],[4] However, the main challenge for the health authorities is to enhance the availability of treatment and make it more affordable for people from all walks of life.[3] This is extremely important as still the world has no vaccine for the disease.[1]

Moreover, in the current set-up, best results can be obtained by strengthening the implementation of primary prevention strategies, such as maintaining hand hygiene, safe handling of biomedical waste, comprehensive screening of blood and blood products, training of health staff, and secondary and tertiary prevention strategies, such as educating people about care and treatment avenues, immunization with hepatitis A and B vaccines to minimize the risk of confection, and further damage to liver, appropriate management, continuous monitoring of the progress.[1],[2]

Owing to the availability of effective therapy, it has been decided to eliminate the disease as a public health problem by 2030 by ensuring a 90% reduction in incidence and 65% reduction in liver-related deaths.[1],[5] Infact, new recommendations have been released for the screening, care and treatment of chronically infected patients. Thus, there is a great need to create awareness among all the stakeholders, develop partnerships to expand the reach of services, formulate evidence-based policy, intensify focus on prevention of disease transmission, and upscale screening and treatment services.[1],[2],[5]

To conclude, hepatitis C is a global public health concern and it is the need of the hour to implement appropriate measures to minimize the adverse consequences of the disease both on masses and the health system.

Acknowledgement

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
World Health Organization. Hepatitis C-Fact sheet; 2016. Available from: http://who.int/mediacentre/factsheets/fs164/en/. [Last accessed on 2016 August 8].  Back to cited text no. 1
    
2.
Abdo AA. Hepatitis c eradication: It's now or never let's get to work. Saudi J Gastroenterol 2016;22:249-50.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Zare F, Fattahi MR, Sepehrimanesh M, Safarpour AR. Economic burden of hepatitis C virus infection in different stages of disease: A report from southern Iran. Hepat Mon 2016;16:e32654.  Back to cited text no. 3
[PUBMED]    
4.
Rodriguez C, Reynolds A. Accessing the cure: helping patients with hepatitis C overcome barriers to care. Am J Manag Care 2016;22:s108-12.  Back to cited text no. 4
[PUBMED]    
5.
Bourgeois S, Blach S, Blach C, Laleman W, Matheï C, Mulkay JP. Achieving WHO recommendations for hepatitis C virus elimination in Belgium. Acta Gastroenterol Belg 2016;79:222-6.  Back to cited text no. 5
    

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Correspondence Address:
Saurabh R Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur, Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.217529

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