By Faranak Bakhtiari

New outbreak of hepatitis: can we step toward elimination?

July 27, 2022 - 17:3

TEHRAN – The world is currently facing a new outbreak of unexplained acute hepatitis infections affecting children. The infection does not appear to belong to any of the known 5 types of hepatitis viruses of A, B, C, D, and E.

July 28 is observed each year as World Hepatitis Day to raise awareness of viral hepatitis, which causes inflammation of the liver that leads to severe disease and liver cancer.

This new outbreak brings focus to thousands of acute viral hepatitis infections that occur among children, adolescents, and adults every year. Most acute hepatitis infections cause mild disease and even go undetected.

But in some cases, they can lead to complications and be fatal. In 2019 alone, an estimated 78,000 deaths occurred worldwide due to complications of acute hepatitis A to E infections.

Global efforts prioritize the elimination of hepatitis infections B, C, and D infections. Unlike acute viral hepatitis, these 3 infections cause chronic hepatitis that lasts for several decades and culminates in over 1 million deaths per year from cirrhosis and liver cancer.  These 3 types of chronic hepatitis infections are responsible for over 95 percent of hepatitis deaths.

July 28 was chosen because it is the birthday of Nobel-prize-winning scientist Dr. Baruch Blumberg, who discovered the hepatitis B virus (HBV) and developed a diagnostic test and vaccine for the virus. 

Some 1.5 million Iranians are diagnosed with hepatitis B and less than 200,000 people with hepatitis C; nearly 3,000 people are infected with hepatitis C each year.

Iran is planning to provide free diagnosis and treatment services to people who are suffering from hepatitis and eradicate the disease by 2030.

By 2030, if we could reduce the incidence of hepatitis by up to 90 percent and decrease mortality by 65 percent, we would have implemented the elimination program as planned by the World Health Organization.
Low coverage of testing and treatment is the most important gap to be addressed in order to achieve global elimination goals by 2030.

Iran's challenges in full elimination of hepatitis C

Complete control of hepatitis C in Iran with the global “point elimination” strategy needs to address several key challenges. One of these challenges is the lack of accurate statistics on people at high risk for hepatitis C, Amir Ali Sohrabpour, the head of the Iranian Hepatitis Network said.

July 28 is observed each year as World Hepatitis Day to raise awareness of viral hepatitis.

While it is necessary to identify 20,000 patients with hepatitis C in Iran annually, only 10 percent of hepatitis C patients have been identified; Therefore, it seems that the challenge of identifying and accurate statistics of high-risk groups in Iran needs a more immediate solution, he added. 

On the other hand, the provinces with high hepatitis C prevalence have not yet been fully identified but is planned to be done, and the country's medical universities can play an important role, while the prison organization can also help hepatitis network by identifying patients to determine how many prisoners are infected with hepatitis C, he emphasized.

There are 1.5 million drug users in Iran, 300,000 of whom are injecting drugs, but one of the challenges is the need for a full treatment of these high-risk groups, including adequate funding for diagnostic tests and distribution of free medicine, he stated.

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