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Hepatitis is an inflammation of the liver, caused by hepatitis viruses or even other infections, toxic substances such as alcohol and drugs, and autoimmune diseases. There are five main hepatitis viruses, of which type B and type C are the most common and lead to chronic disease, including cirrhosis and liver cancer.
Hepatitis has been recognised as a public health problem in India. In 2018, the Government launched the National Viral Hepatitis Program to combat this disease by providing screening and treatment services. This is in line with the United Nations\u2019 Sustainable Development Goal of combating various viral diseases.<\/p>\n
Hepatitis Virus<\/strong><\/em><\/p>\n Hepatitis A (HAV)<\/strong><\/em><\/p>\n Causes \/ Transmission Prevention:<\/strong> Safe drinking water, hygiene and sanitation measures<\/p>\n Treatment:<\/strong> Usually Self-limiting. Supportive care (hydration\/nutrition). No specific antiviral<\/p>\n Hepatitis B (HBV)<\/strong><\/em><\/p>\n Causes \/ Transmission Prevention:<\/strong> Vaccine preventable disease. Hepatitis B Vaccine under the Universal Immunization Program (birth dose at the earliest and certainly within 24 hours of birth, at 6,10 and 14 weeks of birth)<\/p>\n Treatment:<\/strong> Chronic hepatitis B is managed with antiviral medication amongst those eligible as per the national guidelines<\/p>\n Hepatitis C (HCV)<\/strong><\/em><\/p>\n Causes \/ Transmission Prevention:<\/strong> Adopting harm reduction measures (needle exchange), safe injection practices. There is no vaccine to prevent hepatitis C infection<\/p>\n Treatment:<\/strong> Cured in 12-24 weeks in nearly all patients using pan-genotypic regimen with Direct-Acting Antiviral (DAAs) drugs<\/p>\n Hepatitis D (HDV)<\/strong><\/em><\/p>\n Causes \/ Transmission Prevention:<\/strong> By preventing the underlying HBV infection, the Hepatitis B vaccine concurrently confers full protection against HDV infection<\/p>\n Hepatitis E (HEV)<\/strong><\/em><\/p>\n Causes \/ Transmission Prevention:<\/strong> Safe drinking water, hygiene and sanitation measures The key strategies adopted under the NVHCP include preventive, promotive and curative interventions with the focus on awareness generation, increasing access, providing diagnosis and treatment for viral hepatitis to all in need.<\/p>\n The NVHCP program deals with Hepatitis A, B, C, D and E viruses.<\/p>\n -Hepatitis A and E are usually acute, symptomatic and outbreak-prone and monitored through the Integrated Disease Surveillance Program. Seroprevalence is the share of people who test positive for a disease in a sample survey. In India\u2019s 2021 HIV Sentinel Surveillance data, about 0.85% of people tested positive for Hepatitis B and 0.29% for Hepatitis C \u2014 roughly 1 in 118 and 1 in 345 people, respectively. The government runs various national health programs that also help in the prevention and treatment of the disease.<\/p>\n Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition program:<\/strong><\/em> To ensure 100% hepatitis B birth dose to all newborns and Hepatitis B immunoglobulin (HBIG) to newborns of positive pregnant women along with hepatitis B birth dose within 24 hours of birth<\/p>\n National AIDS Control Program (NACP):<\/strong><\/em> Screening of high-risk groups for hepatitis B and C either through facility or outreach. The program also has its toll-free number (1800-11-6666) shared with the NTEP, which provides general information about the infection, its prevention, modes of transmission, management and the various service delivery sites strengthened under the program across the country.<\/p>\n Since 2018, India\u2019s National Viral Hepatitis Control Programme has offered free screening and treatment for Hepatitis B and C nationwide. Smart use of local funding, cheaper generic drugs, and existing health programs has helped expand this care further. Services are now moving from district hospitals down to local health centres, bringing testing and treatment closer to everyone. This reflects the spirit of Sabka Saath, Sabka Vikas \u2014 collective effort for inclusive growth, reaching every citizen.<\/p>\n<\/div>\n
<\/strong>-Faecal-oral route via contaminated food\/water
-Poor sanitation and lack of safe drinking water<\/p>\n
<\/strong><\/em>\u2013<\/i><\/b>Most commonly: Mother-to-child at birth
-Contact with infected blood and blood products and body fluids etc<\/p>\n
<\/strong><\/em>-Exposure to blood from unsafe injections\/ procedures
-Sharing needles\/syringes
-Contact with infected blood and blood products and body fluids etc<\/p>\n
<\/strong><\/em>-Contact with infected blood and blood products and body fluids etc
-Infection only amongst some chronic HBV carriers<\/p>\n
<\/strong><\/em>-Faecal-oral route via contaminated food\/water
-Poor sanitation and lack of safe drinking water<\/p>\n
Treatment:<\/strong> Usually Self-limiting. Supportive care (hydration\/nutrition). No specific antiviral drugs<\/p>\nNational Viral Hepatitis Control Program& Others<\/h2>\n
-Free diagnostics and drugs are being made available to all in need, for management of hepatitis C and hepatitis B.
-The program uses a paperless system of recording and reporting for patient management and monitoring through the NVHCP-MIS portal.<\/p>\n
-Universal screening of pregnant women for Hepatitis B.
-Universal Immunisation Program<\/p>\n
-Hepatitis B vaccination of healthcare workers and hepatitis B-screened negative HRGs for infection prevention
-National Tuberculosis Elimination Program (NTEP): \u00a0Use of existing machines under NTEP for molecular testing.
-Blood Transfusion services: Linkage of Hepatitis B\/C positive donors for further management.<\/p>\nCombating Hepatitis<\/h2>\n