According to the World Health Organization (WHO), the battle is on to fight the rising numbers of hepatitis B cases. Medical experts are calling for global action to tackle the viruses that cause the liver disease hepatitis. The first worldwide estimates in drug users show 10 million have hepatitis C while 1.3 million have hepatitis B.
The report that was released to coincide with World Hepatitis Day, is published online July 28 in The Lancet and says only a fraction of those who could benefit are receiving antiviral drugs. Only one in five infants around the world is vaccinated against hepatitis B at birth, the authors say. About 67% of injecting drug users in the world has been exposed to hepatitis C, while around 10% have come into contact with hepatitis B. In the UK, around half of injecting drug users has been infected with the hepatitis C virus, while the rate for exposure to hepatitis B is 9% - the highest in Western Europe.
Those with high prevalence of hepatitis among drug users included Spain (80 percent), Norway (76 percent), Germany (75 percent), France (74 percent), United States (73 percent), China (67 percent), Canada (64 percent), Italy (81 percent), Portugal (83 percent), Pakistan (84 percent), the Netherlands (86 percent), Thailand (90 percent) and Mexico (97 percent). Lower rates were seen in New Zealand (52 percent), Australia (55 percent) and the United Kingdom (50 percent), the researchers noted. The countries believed to have the largest number of IDUs infected with hepatitis C virus (HCV) are China (1.6 million), the United States (1.5 million) and Russia (1.3 million), the investigators found. Rates of hepatitis B infection were 5 to 10 percent in 21 countries and more than 10 percent in 10 countries. The highest rates were in Vietnam (20 percent), Estonia (19 percent), Saudi Arabia (18 percent) and Taiwan (17 percent). The United Kingdom had the highest rate in Western Europe at 9 percent. The rate in the United States was 12 percent.
The study was led by Prof Louisa Degenhardt of the Centre for Population Health, Burnet Institute, Melbourne, Australia, and Paul Nelson from the National Drug and Alcohol Research Centre at the University of New South Wales. They write, “The public-health response to blood-borne virus transmission in injecting drug users has mainly centered on HIV. Maintenance and strengthening of the response to HIV in injecting drug users remains crucial, but the significance of viral hepatitis needs to receive greater attention than it does at present.” “Nonetheless, HCV treatment is underused. Part of the reason for this neglect is the high cost, which will remain a substantial barrier to increasing of treatment coverage in low-resource settings until costs are reduced,” the researchers concluded.
In response to the study Dr Joseph Amon, of Human Rights Watch, New York City, US, said in his commentary, “This study provides us with a first step and powerful data to draw attention to the problem of viral hepatitis in people who use drugs. The next step is to challenge governments to act, and hold them accountable for implementation of rights-respecting and evidence-based programmes.”
Hepatitis is caused by five main viruses - A, B and C, and, more rarely D and E. Hepatitis B is the most common, and can be passed from mother to baby at birth or in early childhood as well as through contaminated injections or injected drug use. Hepatitis C is also spread through using unsterile needles and less commonly through unsafe sex or sharing razors or toothbrushes. The E virus, caught from infected water or food, is a common cause of outbreaks of the disease in developing countries, said the World Health Organization. Many of those carrying hepatitis are not aware they have it and can unknowingly transmit it to others. Hepatitis can lead to cirrhosis, liver failure and liver cancer.
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