Global Rise in Viral Hepatitis Cases Attributed to Limited Access to Diagnosis and Treatment
Deaths from viral hepatitis are increasing worldwide and this group of diseases is already the second leading infectious cause of death on the planet, behind only tuberculosis. According to data from the World Health Organization (WHO), global rates are around 3,500 fatalities per day and 1.3 million per year. Professor Cássia Mendes Correa, from the Faculty of Medicine (FM) of the University of São Paulo, analyzes the growth in the number of cases of these illnesses and discusses the possible reasons for this scenario.
According to the specialist, hepatitis is a very broad term, which means illness due to an inflammatory process of the liver cells, that is, the liver. She says that there are many different infectious agents that cause hepatitis, but when viral hepatitis is discussed, the focus is generally on so-called hepatotropic viruses, which have a more specific affinity for the liver when they cause disease. The hepatitis viruses A, B, C, D and E are considered in this category.
According to the professor, in addition to these viruses, other viral and non-viral infectious agents can also cause liver inflammation. The consumption of alcohol and some medications can also lead to the emergence of acute and chronic hepatitis. “The hepatitis viruses A, B, C, D and E are five completely different agents and each of them has a different epidemiological behavior, there is no single cause to explain the increase in cases or the importance of these viruses”, he explains. she.
Problems caused
According to Cássia, some of these viruses, such as hepatitis A, only cause an acute illness, in which the infection develops in a few weeks and then disappears, leaving no consequences. She says that in other cases, such as those caused by hepatitis B, C and D, in addition to the acute condition, the inflammation can also persist for a long time and evolve into liver damage, which can lead to the emergence of some complications.
“These diseases can persist for many years, sometimes for a lifetime, causing damage to the liver and causing extremely serious chronic complications, such as the emergence of liver cirrhosis and hepatic carcinoma, that is, liver cancer. Viral hepatitis, therefore, is among the most frequent causes of liver transplants and represents important problems in terms of public health”, he analyzes.
Transmission and vaccine
As they are different infectious agents, their transmission is varied and depends on each viral type. Among these factors, we highlight the consumption of contaminated water and food (hepatitis A), unprotected sexual intercourse (hepatitis B, C, delta), contact with contaminated blood (hepatitis B, C, delta) or from mother to child during pregnancy. pregnancy or breastfeeding (more common in hepatitis B). For these reasons, the spread of these diseases is varied throughout the world, but, in general, it is more common in underdeveloped countries and in more vulnerable populations, in which hygiene and basic sanitation conditions are scarce and knowledge of methods of prevention is low.
According to the professor, there are vaccines available for some of these diseases, but many people do not have access to them and the available treatments. She explains that excellent vaccines have already been developed for hepatitis A and B, but there is no immunization against hepatitis C, D and the vaccine against hepatitis E does not yet show efficient results.
According to the professor, hepatitis B and C virus infections have highly effective and available treatments, including in Brazil, provided by the Unified Health System (SUS). She states, however, that some regions of the country have a lack of medical care and difficult access, which is why the inhabitants of these places do not even discover that they are infected and die before seeking treatment.
“But this happens all over the world, our country is privileged because it has a public health policy that at least intends to offer therapy to everyone who has the possibility of seeking a public institution. There are countries in the world where not only is the medicine not available, it is obviously not supplied. So, if I were to summarize two major issues that negatively impact the control of these diseases, they would be the lack of diagnosis and access to treatment”, he explains.
Reduction of cases
According to Cássia, if health organizations were able to make treatments available to all populations in the world, even the most needy, it would be possible to eliminate viral hepatitis, that is, to drastically reduce the number of cases, deaths and health complications. She highlights that this elimination is different from eradication, which means the complete extinction of a disease in the world.
“This elimination would be possible because, for most of these diseases, there is a vaccine and treatment. So, if we were able to offer diagnosis and treatment to the world population in a democratic and universal way, it would be possible, through mathematical models to prove this, to eliminate hepatitis throughout the world”, he concludes.