Hepatitis Kills Thousands Daily, Warns WHO

By Seliphar Machoni 

Hepatitis is the second leading infectious cause of death globally, causing 1.3 million deaths per year, on par with tuberculosis. This information comes from the World Health Organization's Hepatitis Report 2024.

The report also emphasizes that, despite the availability of better diagnostic and treatment tools and decreasing costs, rates of testing and treatment coverage have stalled.

New data reveals that the estimated number of deaths from viral hepatitis rose from 1.1 million in 2019 to 1.3 million in 2022. Of these deaths, 83 percent were caused by hepatitis B and 17 percent by hepatitis C. Every day, 3,500 people worldwide die from hepatitis B and C infections.

"This report presents a concerning picture: even though there has been progress in preventing hepatitis infections globally, death rates are increasing due to the low number of people being diagnosed and treated for hepatitis. The World Health Organization is committed to supporting countries in utilizing all available tools, at affordable prices, to save lives and reverse this trend," the report states.

The report indicates that in 2022, 254 million people were living with hepatitis B and 50 million with hepatitis C. Half of the burden of chronic hepatitis B and C infections is among individuals aged 30-54, while 12 percent affects children under 18 years old. Men account for 58 percent of all cases.

According to the latest incidence data, there was a slight decrease compared to 2019, but the overall incidence of viral hepatitis remains high. In 2022, there were 2.2 million new infections, down from 2.5 million in 2019.

This includes 1.2 million new hepatitis B infections and nearly 1 million new hepatitis C infections. More than 6,000 people become newly infected with viral hepatitis each day.

"Over 250 million people live with chronic hepatitis B infection, leading to increased deaths each year. Most cases of chronic hepatitis B (CHB) worldwide result from mother-to-child transmission at or soon after birth. The World Health Organization's Global Health Sector Strategy outlines actions and targets to eliminate viral hepatitis by 2030, aiming to reduce new infections and deaths to half a million each globally, a reduction of 90 percent and 65 percent, respectively."

Globally, only 13 percent of people living with chronic hepatitis B infection have been diagnosed, and approximately three percent, or seven million, have received antiviral therapy as of the end of 2022. These numbers fall far short of the global targets to treat 80 percent of people living with chronic hepatitis B and C by 2030.

The burden of viral hepatitis also varies across regions. The WHO African Region carries 63 percent of new hepatitis B infections, but only 18 percent of newborns in the region receive the hepatitis B birth-dose vaccination.

In the Western Pacific region, which accounts for 47 percent of hepatitis B deaths, treatment coverage among diagnosed individuals stands at 23 percent, a figure too low to reduce mortality.

Furthermore, despite the availability of affordable generic viral hepatitis medicines, many countries fail to procure them at the lower prices.

The WHO report outlines a series of actions to promote a public health approach to viral hepatitis, with the goal of accelerating progress toward ending the epidemic by 2030. These actions include expanding access to testing and diagnostics, strengthening primary care prevention efforts, and transitioning from policies to implementation for equitable treatment.

However, funding remains a challenge, as current levels are insufficient to meet the needs, according to the agency. WHO attributes this to a combination of factors, including limited awareness of cost-saving interventions and tools, as well as competing health priorities.

The new report also presents strategies for countries to address these inequities and access tools at the most affordable prices available.

According to the Ministry of Health, Hepatitis is unevenly distributed among counties and populations in Kenya. Approximately 1.9 million people in the country are infected with Hepatitis B and C virus (HBV & HCV), with HBV being the more prevalent type at 1.56 million cases this is as per 2022 report.

Experts have identified traditional cuts and markings on the body as the primary contributing factor to the high prevalence of Hepatitis B in three specific counties. These counties, Turkana, Baringo, and Migori, have reported prevalence rates of over 10 percent, with Turkana having the highest rate at 16.8 percent.

As the name suggests, hepatitis refers to inflammation of the liver. It is important to understand the distinction between viral and non-viral hepatitis.

Viral hepatitis is the most common form and can be caused by viruses A, B, C, D, and E.

Hepatitis A is prevalent in areas with limited access to clean water, but fortunately, there is a vaccine available.

In contrast, Hepatitis B is caused by a virus that can only be transmitted through direct contact with infected blood and body fluids, such as through intravenous drug use. There is a vaccine for Hepatitis B, as well as several antiviral treatments.

Similar to Hepatitis B, Hepatitis C is transmitted through blood, poorly controlled medical procedures, and body fluids. Unfortunately, there is no vaccine available for Hepatitis C.

Hepatitis D requires a pre-existing infection with the Hepatitis B virus. The combination of Hepatitis B and D has the most severe effects; however, vaccination against Hepatitis B is fully effective against Hepatitis D.

Lastly, Hepatitis E, like Hepatitis A, is commonly found in areas with inadequate clean water sources, but there is currently no vaccine for this type.

On the other hand, there are non-viral causes of liver inflammation, including various parasites and bacteria. Fortunately, specific treatments exist for most of these cases once the cause is identified.

Alcohol-related liver damage is one of the leading causes of non-infectious hepatitis. Chronic alcohol consumption can lead to inflammation, cirrhosis, and even liver cancer. It's important to note that alcohol-induced hepatitis is not contagious and cannot be transmitted like a viral infection. 

However, heavy drinking can have a "viral" influence in social settings, as people who drink together may reinforce behaviors that contribute to alcohol-induced hepatitis. Drinking excessively, whether in a single instance or over time, can have severe consequences on the body's organs. Of all the organs affected by alcohol-related damage, the liver is the most well-known non-brain target. Due to its role in metabolizing alcohol, the liver is particularly susceptible to harm caused by excessive alcohol consumption. People who heavily consume alcohol for an extended period are at a higher risk. 

However, it's important to note that not everyone who develops alcohol-induced hepatitis fits this pattern. Some individuals have a greater sensitivity to alcohol, and even moderate alcohol use can provoke liver reactions. On the other hand, some individuals may consume larger quantities of alcohol without suffering from hepatitis.

Genetic variations may partially account for these differences. A family history of alcohol use disorder or liver disease can increase the risk of experiencing alcohol-induced hepatitis. Additionally, gender also influences alcohol tolerance, with those assigned male at birth generally able to handle more alcohol compared to those assigned females at birth. However, it is essential to recognize that each person is unique, and it is difficult to define a universally "safe" amount of alcohol.

Unfortunately, there is no specific medical treatment for alcohol-induced hepatitis. The main objective is to alleviate liver inflammation, aid in the healing process, manage complications, and provide support throughout the individual's recovery. Long-term lifestyle changes and abstaining from alcohol are crucial for successful recovery.