Pakistan hepatitis-C scenario — where we go from here?

Rawalpindi : Pakistan has the highest prevalence of hepatitis – C in the world as five per cent of our population suffers from hepatitis–C and we have around eight million patients of which only 20 per cent know that they are infected.

Less than five per cent of those living with the disease are getting treatment, mostly through private sector healthcare facilities. The World Health Assembly pledged to Eliminate hepatitis–C from the world by 2030 and we are signatory to that but we are still far away from the targets while countries like Egypt are on the way towards elimination.

President Pakistan Society for the Study of Liver

Diseases and Pakistan Society of Gastroenterology and G I Endoscopy Professor of Medicine Hepatologist Brigadier (r) Dr. Masood Siddiq expressed this while talking to ‘The News’ on what is needed to get Pakistan rid of hepatitis that is costing huge to poor families and has a great impact on socio-economic front.

He added hepatitis is epidemic in Pakistan. Hepatitis A & E spread due to contaminated food and water may not be considered as serious disease as these are self-limiting in 4-8 weeks without becoming chronic. Patients recover fully and liver is back to normal but hepatitis B & C are serious problems due to progressive damage as a result of chronic disease, he said.

Patients suffering from hepatitis–C may develop abdominal distention due to water accumulation, become unconscious, vomit blood and develop liver cancer. Hepatitis B is preventable due to cheap, very effective three doses of vaccine but unfortunately there is no vaccine against hepatitis–C, said Dr. Masood.

He said the most disturbing fact is that both hepatitis B & C spread mostly due to faulty healthcare delivery system as a result of reusing of injection needles, surgical instruments, contaminated blood and products, ear, nose piercing and tattooing.

Unfortunately, he added, Pakistan has got the highest number of therapeutic injections 12 to 15 per person per year in the world, most of the time unnecessarily.

He said reducing the incidence of Hepatitis C infection is a key to achieving hepatitis–C elimination in our country. We have large number of infected individuals second only to China. On the basis of current management practices, the hepatitis –C burden would continue to remain substantial, he said.

Referring to an article published recently by Professor Fasiha Kanwal and her colleagues from the US, he said from 2015 to 2030, a total of 1.44 million people could die of hepatitis-C infection and of them 48 per cent patients would be less than 50 years of age.

He said the article states that scaling up hepatitis–C testing and treatment could avert 323000 liver-related deaths every year and scaling up hepatitis C testing using innovative diagnostics could save $2.6 billion during the same period.

Professor Masood believes that hepatitis–C elimination is feasible but substantial efforts are needed, “at least 25 million people would need to be screened every year to diagnose 900000 hepatitis–C infections, and at least 700000 patients would need treatment per year.”