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Table of Contents   
LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 5  |  Page : 1364-1365
Preventing the acquisition and progression of chronic Hepatitis B infection in middle and low income nations: World health organization


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

Click here for correspondence address and email

Date of Web Publication6-Nov-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Preventing the acquisition and progression of chronic Hepatitis B infection in middle and low income nations: World health organization. Ann Trop Med Public Health 2017;10:1364-5

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Preventing the acquisition and progression of chronic Hepatitis B infection in middle and low income nations: World health organization. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Dec 5];10:1364-5. Available from: http://www.atmph.org/text.asp?2017/10/5/1364/196619


Dear Sir,

Hepatitis B is a viral infectious disease of the liver presenting in both acute and chronic forms like cirrhosis and malignancy, which are fatal complications.[1],[2] In fact, the current global estimates reflect that in excess of 235 million individuals present with the chronic infection, and 0.78 million people die each year due to the associated complications worldwide.[1] Furthermore, the disease has been acknowledged as a global concern, with maximum prevalence of the chronic infection has been observed in sub-Saharan Africa and East Asian region.[1],[2]

Even though the disease can be transmitted by various modes; nevertheless, the development of chronic infection is extremely high among infants acquiring the infection from their mother during childbirth, and those children who contract the infection before attaining 6 years of age.[1],[3] Moreover, infections in 90–95% of the adults will resolve on their own within 1 year of being infected.[1] From the clinician's perspective, it is quite difficult to identify the infection and differentiate it from other viral agents, and thus serological tests have been advocated for diagnosis, differentiation of acute and chronic infections, and even monitor the progress of the disease.[4],[5] Although, no specific therapy is available for the acute stages of the infections, antiviral drugs have been recommended to reduce the incidence of liver malignancy, halt the advancement of cirrhosis, and enhance the survival chances.[5] Nevertheless, the access to timely diagnosis and treatment options is quite minimal, especially in low- and middle-income nations, and hence+ poor prognosis has been associated with most of the patients.[4]

Acknowledging the serious complications associated with the chronic infections, high fatality, and absence of specific and effective drugs, there is an extreme need to focus efforts on the prevention of disease.[3],[4],[5] Hepatitis B vaccine is the best bet for preventing the infection, development of chronic disease and liver cancer due to the disease in almost 95% of the cases.[1] It has been recommended to administer the vaccine to all the infants either in the form of three or four doses, with the first dose at birth, and the latest by 14 weeks of age.[1] In addition, vaccination has been recommended for people living in endemic regions or those from high-risk groups like repeated blood transfusions, dialysis patients, those with multiple sexual partners, health care workers, and so on.[1],[5]

In order to streamline the entire process, the World Health Organization has released specific recommendations for the care and treatment of chronic patients of the disease by encouraging the use of simple and noninvasive diagnostic tests to ascertain the stage of liver disease and treatment eligibility, prioritize the delivery of treatment based on the disease stage, and the necessity to continue monitoring and lifelong treatment to assess the disease progression or drug toxicity.[5] Further, the importance of other measures like implementation of blood safety strategies, safe injection practices, minimizing the administration of injections, creating awareness about safer sex practices, and promoting easy access to all diagnostic-therapeutic-supportive services, can also not be undermined in preventing the risk of disease transmission.[1],[2],[4],[5]

To conclude, hepatitis B is a global public health concern with an extremely poor outcome for the chronic infections. Thus, the need of the hour is to strengthen the immunization activities and expand the reach of diagnostic and treatment option modalities, especially in low- and middle-income nations.

Acknowledgment

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 B-Fact sheet No. 204; 2015. Available from: http://who.int/mediacentre/factsheets/fs204/en/. [Last Accessed on 2016 June 5].  Back to cited text no. 1
    
2.
Salehi-Vaziri M, Sadeghi F, Almasi Hashiani A, Gholami Fesharaki M, Alavian SM. Hepatitis B virus infection in the general population of Iran: An updated systematic review and meta-analysis. Hepat Mon 2016;16:e35577.  Back to cited text no. 2
[PUBMED]    
3.
Borchardt SM, Kocharian A, Hopfensperger D, Davis JP. Prevention of perinatal transmission of hepatitis B virus: Assessment among Wisconsin maternity hospitals. WMJ 2016;115:74-9.  Back to cited text no. 3
[PUBMED]    
4.
Wilson EM, Tang L, Kottilil S. Eradication strategies for chronic hepatitis B infection. Clin Infect Dis 2016;62:S318-25.  Back to cited text no. 4
[PUBMED]    
5.
World Health OrganizationGuidelines for the prevention, care and treatment of persons with chronic hepatitis B infection. GenevaWHO press1-26.  Back to cited text no. 5
    

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Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, 3rd Floor, 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: 10.4103/1755-6783.196619

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