Today is #WorldHepatitisDay – Impact of Covid-19 on Hepatitis

Educational: Hepatitis C

The 73rd World Health Assembly took place virtually on Monday 18 and Tuesday 19 May and the World Hepatitis Alliance submitted a written intervention, which drew on findings from their global Covid-19 survey, to highlight the impact of Covid-19 on people living with viral hepatitis and on hepatitis services.

The statement is part of WHA’s continuous efforts to ensure that hepatitis remains firmly on the global health agenda. It urges Member States to seize the unprecedented opportunity presented by the current pandemic to make the most of synergies in screening opportunities and embed hepatitis elimination within evolving health systems.

The intervention states:

“The Covid-19 pandemic presents the biggest global health threat in a generation. Whilst the pandemic is affecting nearly everyone, it is having the greatest impact on the populations most undeserved by health systems. These same communities are disproportionately affected by viral hepatitis, a disease that claims more than 4,000 lives every day. The viral hepatitis community stands ready to play its part in tackling the Covid-19 pandemic to safeguard the lives of these at-risk and marginalised populations.”

The Covid-19 pandemic has severely disrupted hepatitis elimination programmes across the world. Research conducted by the World Hepatitis Alliance reveals only 10% of services are still functioning as normal. Without the availability of effective prevention, testing and treatment services, hopes of eliminating hepatitis by 2030 are diminished, and thousands of people affected by viral hepatitis are left facing an uncertain future.

Towards the end of last year, research showed that 78% of people using needle and syringe programmes in community pharmacies who opted to test for hepatitis C would prefer to receive their hepatitis C treatment from the pharmacy. The findings came from the second phase of a pilot study carried out by the London Joint Working Group on Substance Use and Hepatitis C, which co-ordinates efforts to improve prevention, diagnosis and treatment of hepatitis C in people who use drugs in the capital.

Hepatitis C is a viral infection, which causes inflammation of the liver. It is spread through contact with the blood of an infected person. Sharing injecting needles and equipment with someone who is infected is the most common way to get hepatitis C in Ireland.

About 25% of people who are infected clear the virus within one year of infection. The remaining 75% develop chronic (long-term) infection. This can cause serious liver disease, including cirrhosis (scarring of the liver) and liver cancer. This liver damage occurs gradually over 20-30 years in people with chronic infection. Hepatitis C became a notifiable disease in Ireland in 2004.

New treatments for hepatitis C have become available in recent years. These result in a cure for about 95% of people who are infected. In the last four years, over 4,000 people have been cured of hepatitis C in Ireland – but up to three times that number could be infected with the virus and not know.

Direct Acting Antivirals – DAA are the safest and most effective medicines for treating Hepatitis C today. Some types of hepatitis C can be treated using more than 1 type of DAA. Sofosbuvirvelpatasvir is a pangenotypic NS5A-NS5B inhibitor single-pill combination regimen that has potent activity against hepatitis C virus (HCV) genotypes 1, 2, 3, 4, 5, and 6. It provides a much-needed option for patients with HCV genotype 3 infection, including those with compensated cirrhosis.

Hepatitis is referred to as “a silent killer”, as the viral infection has no symptoms in many cases. It affects people in different ways and has several stages:

• Incubation period. This is the time between first exposure to the start of the disease. It can last anywhere from 14 to 80 days, but the average is 45
• Acute hepatitis C. This is a short-term illness that lasts for the first 6 months after the virus enters the body. After that, some people who have it will get rid of, or clear, the virus on their own.
• Chronic hepatitis C. If the body doesn’t clear the virus on its own after 6 months, it becomes a long-term infection.
• Cirrhosis. This disease leads to inflammation that, over time, replaces healthy liver cells with scar tissue. It usually takes about 20 to 30 years for this to happen, though it can be faster for those who drink alcohol or who have HIV
• Liver cancer. Cirrhosis makes liver cancer more likely.

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