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HYDERABAD, Jul 28 (APP):On the occasion of World Hepatitis Day, a one-day awareness event regarding prevention and treatment of hepatitis was organized by the Director of the Asian Institute of Medical Sciences, Professor Dr. Sadiq Memon, a renowned gastroenterologist of the country.
The event featured the participation of renowned liver specialists, physicians, senior doctors, principals of various schools and colleges, and individuals from various walks of life.
While addressing the gathering, Professor Dr. Sadiq Memon said that every year on July 28, the global community observes World Hepatitis Day, aimed at raising awareness about the severity, diagnosis, treatment, and prevention of hepatitis, particularly viral hepatitis.
The World Health Organization (WHO) has set a target to reduce new infections by 90% and deaths caused by hepatitis by 65%. To achieve this, global policies, vaccination programs, and diagnostic systems are being introduced. Despite these efforts, Egypt is the only country that has successfully met this target, thanks to timely decisions, a coordinated strategy, and effective implementation at the government level.
In Pakistan, gastroenterologists have repeatedly provided the government with comprehensive policies and practical suggestions, but unfortunately, these policies have not yet been implemented. Professor Dr. Sadiq Memon emphasized the need for the government to take hepatitis, a rapidly spreading disease, seriously and take swift, effective measures so that the 2030 target can be achieved. He called it a challenge, but one that humanity could overcome with proper strategies, vaccines, modern treatment, and public awareness.
Dr. Sadiq Memon informed that according to the latest WHO statistics, nearly 300 million people worldwide are affected by Hepatitis B, and around 55 million people suffer from Hepatitis C. Every year, 1.3 million people lose their lives due to these viruses, with conditions like jaundice, liver cancer, and severe liver diseases, resulting in about 3,500 deaths every day. Interestingly, two-thirds of those affected by Hepatitis B are unaware that they carry the virus, and only 13.5% of patients have access to diagnostic services. Hepatitis C has a better diagnosis rate, but it is still limited to only 36%, indicating the urgent need for awareness, screening, and testing campaigns to prevent these diseases globally.
Hepatitis EA primarily spreads through contaminated water in developing countries, causing 55,000 deaths annually. The speakers at the event stated that Hepatitis B and C have become a major public health issue in Pakistan. According to research and government statistics, around 15 million people in Pakistan are affected by this epidemic, including approximately 4 million with Hepatitis B and 8.8 to 10 million with Hepatitis C.
The prevalence of Hepatitis B in the general population is about 2.5%, while Hepatitis C affects around 4-5%. In certain regions like Sindh and Balochistan, the prevalence is higher, with some areas in Sindh reporting over 10%. Every year, around 50,000 to 100,000 new cases are reported in Pakistan, and approximately 12,000 people die from this disease.
The main causes of Hepatitis in Pakistan include unsafe medical practices, reused syringes, non-sterile equipment, substandard blood transfusions, and injection drug use. Among drug users (IDUs), 15% have Hepatitis B, and an alarming 68% have Hepatitis C.
Hepatitis B and C are considered the most dangerous types of hepatitis and are known as silent killers because they often show no symptoms in the early stages but can cause irreversible liver damage.
Hepatitis A and E spread primarily through contaminated water and unsafe food, with the spread being more common in developing countries. Hepatitis A usually affects children, while Hepatitis E is particularly dangerous for pregnant women and adults.
According to global statistics, nearly 20 million cases of Hepatitis E are reported each year, leading to 35,000 to 55,000 deaths. In Pakistan, several major outbreaks of Hepatitis E have been reported, especially in Karachi, Islamabad, Lahore, and flood-affected areas where the lack of clean drinking water and poor sewage systems has accelerated the spread of the virus. In pregnant women, the fatality rate of Hepatitis E infection ranges from 16-33%, often resulting in acute liver failure.
Recent research from the Asian Institute of Medical Sciences (2024) shows that 68% of adults in Pakistan have antibodies (IgG) against Hepatitis E, indicating prior exposure to the virus. According to the findings, 90% of children in Pakistan will be infected with Hepatitis A by the age of 6, often without any symptoms. A safe and effective vaccine for Hepatitis A has been available for decades and is part of immunization programs in many countries, though in Pakistan, it is not part of the national vaccination program but is available in the private sector.
The recent advancement regarding Hepatitis E is that a vaccine is now globally available, and it has been introduced in Pakistan as well. This vaccine is an effective preventive measure against Hepatitis E, especially in high-risk areas or for pregnant women. Both Hepatitis A and E are mostly symptomatic and tend to resolve on their own, but complications are more common in individuals with weakened immune systems and pregnant women.
Globally, Hepatitis B remains a serious public health issue, with approximately 300 million people affected in 2019. Around 820,000 people die each year due to Hepatitis B-related complications such as severe liver disease, cirrhosis, and liver cancer. The situation in Pakistan is equally alarming. According to the National Survey (2007-2008), the prevalence of Hepatitis B is 2.5%, meaning about 4 million people are affected by Hepatitis B.
In children, the prevalence rate ranges from 1.9% to 3.6%, and the spread can be even higher among specific groups, such as hemophiliacs, thalassemia patients, and pregnant women. Unsafe injections, reused syringes, poor-quality blood transfusions, and mother-to-child transmission are the main causes of the spread of Hepatitis B.
Hepatitis B is preventable through an effective vaccine. In developed countries, this vaccine is a mandatory part of immunization programs, but in Pakistan, the vaccination rate for newborns within 24 hours of birth is very low, around 45%. To increase this rate, the government should implement a nationwide HBV Birth Dose Vaccination Program and make it accessible to rural areas where the disease is more prevalent. In addition, mandatory screening of pregnant women should be introduced to prevent the transmission of the virus from mother to child.
For treatment, antiviral drugs such as Tenofovir and Entecavir are available in Pakistan.
These drugs are provided free of charge by the Sindh government and can prevent the progression of the disease. However, these medications must be taken for life.
Unfortunately, only 13% of people with Hepatitis B in Pakistan are aware of their condition, and less than 5% are receiving treatment.
To bridge this gap, national Hepatitis B screening camps must be established to ensure the timely identification of affected individuals.
Currently, there is no vaccine for Hepatitis C, so the only way to prevent this disease is through public awareness, safe medical practices, and the elimination of unsafe injections. Hepatitis C has a prevalence of 5-7.5% in Pakistan, which is much higher than the global average. If Pakistan does not take immediate action, an estimated 700,000 people could die from Hepatitis C by 2030, with 50% of them under the age of 50.
According to studies conducted in Pakistan and worldwide, only 20% of people are aware that they have Hepatitis C, while 80% remain unaware. Furthermore, only 2% of individuals in Pakistan complete the treatment for Hepatitis C, compared to 20-40% globally. A positive aspect, however, is that Pakistan is one of the few countries where Hepatitis C treatment, such as DAAs (Direct-Acting Antivirals), is among the most affordable globally, costing around PKR 12,000 to 45,000 for a complete course.
DAA treatment can cure up to 97% of Hepatitis C patients in 8-12 weeks. However, access to treatment remains a major issue, as only 22% of diagnosed patients are aware of their condition, and only 2% have started treatment. To address this issue, the government should make DAAs available in public hospitals for free and initiate free screening programs at the district level to ensure the timely diagnosis and treatment of Hepatitis C.
The Sindh government is providing free 3-month treatment for Hepatitis C.