PETALING JAYA: As the world works to eliminate viral hepatitis by 2030, health experts say there must be concerted efforts to address the gaps in the testing and treatment of Hepatitis B and Hepatitis C.

Prof Dr Rosmawati Mohamed (pic), a consultant hepatologist, said although the most common forms of hepatitis virus in Malaysia are Hepatitis A, B and C, the largest disease burden and impact come from Hepatitis B and C, which could result in the long-term serious cirrhosis of the liver (liver scarring) and liver cancer.

“Worldwide, the majority (96%) of deaths are from viral hepatitis due to Hepatitis B and C. However, viral hepatitis is preventable, treatable, and for Hepatitis C, curable with timely treatment.

“It is estimated that (in Malaysia) nearly 3% of adults born before the introduction of Hepatitis B vaccination programme for newborns in 1989 are living with chronic Hepatitis B.

“The prevalence of Hepatitis C infection in Malaysia is 0.4%, amounting to an estimated 90,119 infected population aged above 15 years.

“However, less than 10% of Malaysians living with Hepatitis C are aware that they are infected, while only 17% of those with Hepatitis B have been diagnosed, and as a consequence, only a minority of individuals with Hepatitis C and B have been treated.“This shows that we have a long way to go before achieving the goal of elimination,” Dr Rosmawati said in an interview.

In 1989, Malaysia introduced a Hepatitis B vaccination programme for infants, administering three doses before the age of one.

Dr Rosmawati said the most common transmission mode for Hepatitis B is at birth from an infected mother.

“The key risk factors for Hepatitis C include drug use through injection, tattoos and body piercings, and blood transfusions before 1994 (the year when widespread screening of donated blood began, as Hepatitis C testing was only available worldwide in the early 1990s).

“People who received blood transfusions and blood products prior to 1994 are at risk of being infected with Hepatitis C and should get tested for the virus,” she added.

Dr Rosmawati recommended people undergo Hepatitis B testing at least once in their lifetime, especially those who were born before 1989.

There has been a clear decline in Hepatitis B prevalence since the Hepatitis B vaccination programme for newborns was implemented.

“Unfortunately, there is yet to be a vaccine to combat Hepatitis C,” said Dr Rosmawati.

Hepatitis B treatment is extremely effective in suppressing the virus at a reasonable monthly cost, but in the majority of cases, it must be taken for the rest of one’s life.

“In contrast, Hepatitis C is a curable disease with just 12 weeks of treatment with the availability of generic direct-acting antivirals,” she added.

At the APAC-IRIDS 2024 – International Roche Infectious Disease Symposium 2024, held in Ho Chih Minh City, Vietnam, in June, Director of the Coalition for Global Hepatitis Elimination, Dr John Ward, said the burden of hepatitis is both a tragedy and an opportunity, as these infections are preventable.

During a panel discussion at the symposium, he said the US had moved to a “whole adult population testing policy for Hepatitis B and C, despite the lower prevalence compared to many Asian countries.

“This is important because there are people who were born before the Hepatitis B vaccine was available.

“There are general anti-discrimination policies to ensure access to employment and healthcare for people living with hepatitis,” he said.

World Hepatitis Day is celebrated on July 28.

According to the World Health Organization, 304 million people are living with chronic Hepatitis B or C virus infection.

https://www.thestar.com.my/news/nation/2024/07/26/experts-address-gaps-in-hepatitis-testing-treatment