Ahead of the World Hepatitis Day, Nigerians have been urged to know their hepatitis status towards preventing liver diseases and hepatitis-related deaths.
The Minister of Health, Isaac Adewole, gave this advice on Tuesday at a press briefing in Abuja on the World Hepatitis Day.
The advice came on the same day that the World Health Organisation urged countries to scale up access to Direct-Acting Antivirals, DAAs, a new drug for the treatment of the disease, despite a controversy surrounding the drug.
World Hepatitis Day is marked every July 28 to educate people on Hepatitis and encourage them to go for screening so as to prevent the spread of the disease and get those positive to seek medication.
According to WHO, Hepatitis is a silent killer and kills faster than HIV/AIDS.
An estimated 325 million people were living with chronic Hepatitis infections (HBV or HCV) worldwide in 2015 and 1.34 million people died of the virus globally in 2015, the agency stated.
There are five main types of Hepatitis virus referred to as Types A, B, C, D, and E.
But B and C are on the rise globally and are getting to a burden status requiring quick intervention. Mr. Adewole said they are also becoming difficult to treat, hence the urgent need for people to know their hepatitis status.
“This has made it important to tackle Hepatitis with seriousness. But the good thing is that it can be treated and can be prevented,” the minister said.
“There is vaccine against the B and it is available for adult and also part of the routine immunisation for children especially from birth. It is by putting preventive, treatment and curative measures that we can stop the spread of the disease”, he said.
According to WHO, Hepatitis A and E are typically caused by ingestion of contaminated food or water.
Hepatitis B, C and D usually occur as a result of contact with infected body fluids.
The common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for Hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.
Mr. Adewole explained that people with Hepatitis have symptoms that look like malaria at inception, headache, body aches, yellow eyes among others. When this symptoms present themselves, there is no harm in thinking Hepatitis and testing to know ones status before treatment, he advised.
“We also need to eat well and drink safe water, not alcohol, to develop the immune system as this can help fight against other diseases, not just Hepatitis.
“People should also reduce or not drink alcohol, because it damages the liver and Hepatitis also work on damaging the liver, thereby causing liver diseases such as inflammation of the liver, fibrosis (scarring), cirrhosis or liver cancer, ” Mr. Adewole added.
Mr. Adewole said this year’s theme for the Day, “Eliminating Hepatitis” has great significance to Nigeria because the government and its partners have set a target to eliminate all forms of Hepatitis in the country by 2030.
Wondimagegnehu Alemu, WHO country Representative to Nigeria, in his remark said the international health agency is committed to assisting Nigeria in it fights towards eliminating the disease.
“We are currently working with the government to combat the Hepatitis E outbreak in Borno State, he said.
Mr. Alemu however said there is still more to do as WHO estimate indicates 10 percent of the people living with Hepatitis B are in Nigeria, with most of them unfortunately not aware that they have the disease.
“That is why we are joining the Nigerian government in its campaign to encourage people to go for screening, and if they test positive, they should start treatment as Hepatitis is curable,” he added.
Meanwhile, WHO in a press statement released on Tuesday called for increased access to DAAs.
The new drug has passed clinical trials for use in the African region.
Gottfried Hirnschall, Director of WHO’s Department of HIV and Global Hepatitis Programme, said the revolution in Hepatitis C treatment with DAAs has, for the first time, provided an opportunity for widespread scale-up of curative treatment.
“DAAs have been proven to be safe and effective in clearing the hepatitis C virus from the body, thus preventing life-threatening complications. As an organization whose recommendations are based on scientific evidence, we will continue to monitor the latest research and country experiences to see if there is any need to change our recommendations on DAAs. Currently there is not.”
A recent meta-analysis published by the Cochrane Collaboration on the benefits and harms of DAAs had concluded that there was insufficient evidence to assess whether DAAs had any clinical effects.
The study attempted to assess whether DAAs reduce Hepatitis C-related morbidity and mortality in clinical trials, concluding: “We could neither confirm nor reject that DAAs had any clinical effects.”
However, several professional Hepatitis and liver societies have published rebuttals to this meta-analysis. Editorials in major peer reviewed publications have cited methodological flaws and, critically, insufficient follow-up time in clinical trials to assess any impact on mortality.
As stated in the Lancet editorial, “the scarcity of data for hepatitis C related morbidity and all-cause mortality is unsurprising, given the short follow-up available for many of the trials of DAAs – it takes many years for these outcomes to become apparent.”
According to Marc Bulterys, Team Lead of the Global Hepatitis Programme, “recently available population-level data from several countries indicate that mortality and the need for liver transplantation due to chronic hepatitis C infection have decreased as a result of the introduction of DAA treatment.”
WHO however said it remains committed to promoting widespread access to new and highly effective DAAs, supporting countries to save lives and achieve the hepatitis elimination goals.”
It said it recognises the importance of establishing and maintaining registries and observational cohorts for long-term follow-up of patients treated for chronic hepatitis C infection in national treatment programmes.
According to the health agency, access to Hepatitis C treatment for people living with chronic infection remains insufficient in many countries, resulting in more than 1000 people dying every day and the world has only recently expressed its alarm about the burden of viral hepatitis.
“In most countries, the response is still in an early phase. In recognition of the public health impact of viral hepatitis, the World Health Assembly endorsed the Global Health Sector Strategy on viral hepatitis 2016–2021 in May 2016.
“The strategy calls for the “elimination” of viral hepatitis (including both hepatitis B and C) as a major public health threat by 2030 – defined as reducing new infections by 90% and mortality by 65%”, it added.
Globally, an estimate of 71 million people have chronic Hepatitis C infection and approximately, 399,000 people die each year from liver complications, such as cirrhosis and liver cancer as a result of the disease.
Mr. Adewole said there is no accurate figure on the number of infected people in the country because most Nigerians do not know their status.
However, WHO estimates that about 10 per cent of Nigerians are living with chronic Hepatitis, either B or C.