Health Talk: Taking the road to hepatitis elimination

Each year, July 28 is observed as World Hepatitis Day, as viral hepatitis continues to remain a public health threat, one of the primary causes of liver cancer

The International Agency for Research on Cancer (IARC) recently classified hepatitis D as carcinogenic—cancer-causing—to humans, just like hepatitis B and C.

Hepatitis D, which only affects individuals infected with hepatitis B, is associated with a two- to six-fold higher risk of liver cancer compared to hepatitis B alone, it added. (AP/ Representative photo)

Hepatitis D, which only affects individuals infected with hepatitis B, is associated with a two- to six-fold higher risk of liver cancer compared to hepatitis B alone, it added.

Viral hepatitis – types A, B, C, D, and E – are major causes of acute liver infection. Among these, only hepatitis B, C, and D can lead to chronic infections that significantly increase the risk of cirrhosis, liver failure, or liver cancer.

Each year, July 28 is observed as World Hepatitis Day, as viral hepatitis continues to remain a serious public health threat and one of the primary causes of liver cancer.

Yet most people with hepatitis don’t know they’re infected, says the World Health Organization (WHO). According to the UN health body, types B, C, and D affect at least 300 million people globally and cause at least 1.3 million deaths each year, mainly from liver cirrhosis and cancer.

In a paper published on Monday, The Lancet Commission also mentioned that three in five liver cancer cases happen due to preventable risk factors, including fatty liver, alcohol, and viral hepatitis. It also added that obesity-linked cancer cases are on the rise.

The majority of liver cancer cases can be prevented by reducing levels of viral hepatitis, alcohol consumption, and MASLD (metabolic dysfunction-associated steatotic liver disease – previously called non-alcoholic fatty liver disease), it said.

Liver cancer is already a major cause of death and disability. Globally, it’s the sixth most common cancer and the third leading cause of death from cancer.

Interestingly, the Commission estimated in the paper that at least 60% of liver cancers are preventable via control of modifiable risk factors, including hepatitis B virus (HBV), hepatitis C virus (HCV), MASLD, and alcohol.

While there are preventive measures and treatment available to combat this public health threat, last year’s Global Hepatitis Report underscored some challenges that majorly impact disease management.

According to the report, testing and treatment coverage remain critically low: only 13% of people with hepatitis B and 36% with hepatitis C had been diagnosed by 2022. Treatment rates were even lower – 3% for hepatitis B and 20% for hepatitis C – well below the 2025 targets of 60% diagnosed and 50% treated. Integration of hepatitis services remained uneven: 80 countries have incorporated hepatitis services into primary health care, 128 into HIV programmes, and just 27 have integrated hepatitis C services into harm reduction centres.

The next challenge, according to the report, will be to scale up the implementation of prevention, testing, and treatment coverage. Achieving WHO’s 2030 targets could save 2.8 million lives and prevent 9.8 million new infections. With declining donor support, countries must prioritize domestic investment, integrated services, better data, affordable medicines, and ending stigma, said experts in the report.

“Every 30 seconds, someone dies from a hepatitis-related severe liver disease or liver cancer. Yet we have the tools to stop hepatitis,” WHO director-general Tedros Adhanom Ghebreyesus said in a statement on World Hepatitis Day.

He is right. We have the tools at our disposal; all we need is for stakeholders—governments, civil society, community leaders, etc.—to come together, to jointly work towards eliminating hepatitis.