Rotary & Chennai Liver Fountation organized Viral Hepatitis Elimination Programme. Rotary International President Rtn.Jennifer Jones Participated !

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Rotary International Director Rtn.A.S.Venkatesh and Rotary Districts 2981,2982.3000.3231 and 3232 are glad to host the Rotary International President 2022-23 Rtn Jennifer Jones who is visiting Chennai between 25th July, 2022 and 27th July 2022. A series of programs have been arranged during her visit project launches, meeting Rotary leaders, meeting the Honourable Chief Minister of Tamil Nadu, public image event, meeting the youth and ladies wings of Rotary and press interaction.

Viral hepatitis is one of the leading causes of death globally, accounting for more deaths per year than HIV/AIDS or malaria. Despite killing 1.4 million people every year, the awareness levels has been dismally low. 290 million people are completely unaware they are living with the virus. This puts them at risk of developing fatal liver disease or unknowingly passing the virus on to others.

Viral hepatitis is increasingly being recognized as a public health problem in India.

Hepatitis A Virus (HAV) and Hepatitis E Virus (HEV) are important causes of acute viral hepatitis and Acute Liver Failure (ALF). Due to paucity of data, the exact burden of disease for the country is not established. However, available literature indicates a wide range and suggests that HAV is responsible for 10-30% of acute hepatitis and 5-15% of acute liver failure cases in India. It is further reported that HEV accounts for 10-40% of acute hepatitis and 15-45% of acute liver failure.

Hepatitis B surface Antigen (HBsAg) positivity in the general population ranges from 1.1% to 12.2%, with an average prevalence of 3-4%. Anti-Hepatitis C virus (HCV) antibody prevalence in the general population is estimated to be between 0.09-15%. Based on some regional level studies, it is estimated that in India, approximately 40 million people are chronically infected with Hepatitis B and 6-12 million people with Hepatitis C. Chronic HBV infection accounts for 40% of Hepato-cellular Carcinoma (HCC) and 20-30% cases of cirrhosis in India. Chronic HCV infection accounts for 12-32% of HCC and 12-20% of cirrhosis.

In 2016, the WHO Global Health Sector Strategy (GHSS) on viral hepatitis provided the initial roadmap for the elimination of viral hepatitis as a public health problem by 2030-a 90% reduction in incidence and a 65% reduction in mortality by 2030, compared with a 2015 baseline. This new guidance provides a framework for countries to measure their efforts in reducing both new infections of hepatitis B and C and deaths from liver cirrhosis and cancer alongside reaching high coverage (>90%) of programme interventions to ultimately confirm attainment of elimination.

These include preventative interventions, such as hepatitis B infant and birth dose vaccination, blood and injection safety and harm reduction, as well as HBV/HCV testing and treatment, and must be maintained for 2 years. This interim guidance aims to promote a standardized public health approach for viral hepatitis elimination and recognizes regional and country context and burden of viral hepatitis B and C.

Hepatitis B Vaccine Recommendations

International: The World Health Organization (WHO) recommends the hepatitis B vaccine for all new-born’s, children up to 18 years of age, and all adults at higher risk for infection (see below for risk factors).

United States: The U.S. Centres for Disease Control and Prevention (CDC) recommends the hepatitis B vaccine for all new-born’s, children up to age 18, adults 19-59 years of age, and adults 60 and older who are at high-risk for infection (see below for risk factors).

Persons most at risk for infection:

Every person may be at some risk for a hepatitis B infection during their lifetime, so all people should consider getting the hepatitis B vaccine. However, some groups are more likely to be exposed to the hepatitis B virus. They are:

Infants born to mothers who are living with hepatitis B

All infants, beginning at birth

Unvaccinated children aged <19

Susceptible sexual partners of people with hepatitis B infection

Sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., more than one sex partner during the previous six months)

Persons seeking evaluation or treatment for a sexually transmitted infection

Men who have sex with men

● People with current or recent drug use

Susceptible household contacts of people with hepatitis B infection.

Healthcare and public safety workers at risk for exposure to blood

● Persons with end-stage renal disease, including pre-dialysis, hemodialysis, peritoneal dialysis, and home dialysis patients

Residents and staff of facilities for persons with developmental disabilities

● ● Travelers to and families adopting from countries where hepatitis B is common (e.g. Asia, Africa, South America, Pacific Islands, Eastern Europe, and the Middle East) Persons with chronic liver disease, other than hepatitis B (e.g. cirrhosis, fatty liver disease, etc.)

Persons with hepatitis C infection

Persons with HIV infection

People with diabetes, as decided by their provider

● All persons seeking protection from HBV infection – acknowledgment of a specific risk factor is not a requirement for vaccination.

Vaccination Drive

The hepatitis B Vaccination for new-born’s is about 50-60% and there is no policy as of now to vaccinate adults, except that in the urban population the pregnant mothers are being vaccinated.

We at Rotary District 3232 and Chennai Liver Foundation join hands to bridge this gap and start a massive vaccination drive. It has been proposed to begin with a target of 100 000 doses of hepatitis B vaccinations and then scale it up to 1 million doses in a phased manner.

Special Camps will be conducted for this vaccination drive. Collaboration with the government will give access to all the primary health centre and district general hospitals where the vaccine will be given free of cost to adults.

This will be the first ever mega launch by Rotary and Chennai Liver Foundation. It has to be said Rotary has played a pivotal role in elimination of Polio and such initiatives will definitely help us achieve in elimination of Viral hepatitis as mandated by the WHO.

The Programme has been initiated by Chennai Liver Foundation & powered by Rotary for social mobilisation & community outreach.

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