Viral hepatitis is on the rise in Pakistan. Though waterborne infections including hepatitis E and A are self-curative, the blood borne hepatitis B and C are among the top-ten causes of mortality globally and was responsible for an estimated 1.34 million deaths in 2015.

In South-Asia, according to WHO statistics, Pakistan has the world’s second highest prevalence of hepatitis C, second only to Egypt.  In Pakistan, almost 12 million people are suffering from hepatitis B or C.

The disease is known as “silent killer” because of its indolent course, with an asymptomatic phase, lasting for many years. When symptomatic, the Hepatitis B and C can rapidly progress to liver cirrhosis, a condition resulting from irreversible liver damage and ultimately to liver cancer. The definitive cure at this stage is liver transplant, a treatment that is beyond the reach of most Pakistanis, owing to its very high cost. Major risk factors for the transmission of hepatitis B and C infection includes: therapeutic injections, syringe reuse, surgery, improper sterilisation of invasive medical devices, blood transfusion, hospitalisation and sharing of razors while getting shave from barbers.

Some population groups are highly affected by hepatitis B and hepatitis C such as injecting drug users and thalassemia patients.  Prevention is the key to success and education is the basic step towardsachievement. This would include educating health personnel to abandon unnecessary injection practices, aptitude of staff on safe injection practices and effective sharp and waste management.

In the recent years, effective treatment regimens have been introduced for hepatitis C, with a cure rate of above 95%. To conclude, viral hepatitis B and C are fatal disease, if left untreated.  Effective strategies including preventive measures as described and treatment can help in reducing and eventually eliminating the disease from the country. 

The writer is senior instructor, gastroenterology,  Shaukat Khanum Memorial Cancer Hospital and Research Centre.