‘Elimination of hepatitis virus to take several years in India’

By Ahmad Adil

NEW DELHI (AA) – With more than 40 million chronic hepatitis B (HBV) infected people in the country as per estimates by India’s National Center for Disease Control (NCDC), the COVID-19 pandemic has seriously impacted the fight against the disease.

In an exclusive interview with Anadolu Agency on eve of World Hepatitis Day which is being observed on Tuesday, Dr. Yogesh Kumar Chawla, India’s renowned hepatologist, said there were ramifications on patient care, screening, and delivery of services due to disruptions caused by the pandemic.

But he hoped that better investments in the health care system will be able to fix the disease.

India has set up the National Viral Hepatitis Control Program (NVHCP) in July 2018 intending to eliminate viral hepatitis by 2030.

As per NCDC, India constitutes approximately 11% of the estimated global burden, and HBV infection in India is around 3-4 %.

"As of now, the program for hepatitis C treatment has shown excellent results in the states of Punjab and Haryana. The main advantage with HCV (hepatitis C) is that we use short course all-oral direct-acting antiviral agents (DAAs) that can cure HCV. So, despite the lack of a vaccine, we may achieve elimination in 10-15 years," Chawla said, who has been conferred the fourth highest civilian award of the country.

"The HBV (hepatitis B) program will take several decades before any impact is seen in the reservoir of disease as it does not have an effective cure,” he said.

There are five types of viral hepatitis, A, B, C, D, and E.

According to Dr. Chawla, who is also the former director of Chandigarh-based Post Graduate Institute of Medical Education and Research, most of the patients in the country remain unaware, when they carry the disease.

"According to the WHO, nearly 40 million Indians carry the HBV infection, mainly as asymptomatic carriers. It is 100 times more infectious than HIV...most patients are unaware that they carry the virus," he said, adding that patients are getting "diagnosed incidentally".

- Lack of national registry

Describing the lack of a national registry for HBV as a major limitation, he said the NVHCP is expected to fill the gaps for the diagnosis and treatment of Viral Hepatitis.

Asked about a large number of people who are not aware of the infection, Dr. Chawla said since the disease is asymptomatic in the early stages, a "universal stratified screening" should be conducted.

He said besides campaigns to educate school children and public awareness messages about the availability of free treatment, there is a need for safe maternal healthcare, and improved biomedical waste management to combat the disease.

Further, universal immunization for HBV could also be the most cost-effective step.

- Vaccine side effects normal

In a recent study linking the Covishield vaccine with rare autoimmune hepatitis, the noted hepatologist said the benefits of taking the vaccine vastly outweigh the risks.

"Such side effects like thromboses, neurological complaints, autoimmune disease, thyroiditis, etc. have been reported globally," he said.

He added that the risk of dying from COVID-19 is far greater than from liver disease.

Covishield is the Indian-made version of AstraZeneca's Vaxzevria jab, which has been authorized in the EU.

"Until awareness improves, the people will not demand better quality services. Northern Punjab state was first to openly talk about the prevalence of hepatitis C and prevalence was around 3%. Subsequently, they launched a program five years ago," he said.