Hepatitis: Global Effort to Eradicate This Disease Gaining Ground

On 2018's World Hepatitis Day, SCOR Global Life's R&D Medical Director Dr. Gabriela Buffet shares 4 important takeaways about this widespread disease:

HEPATITIS - A MAJOR GLOBAL HEALTH PROBLEM

Viral hepatitis kills people daily mainly due to major liver damage (hepatitis A, B, D, E or chronic), but also because of extrahepatic manifestations. At the end of 2015, there were approximately 325 million people living with chronic hepatitis worldwide. An estimated 257 million people were living with hepatitis B (HBV) infection, and 71 million individuals were living with hepatitis C (HCV) infection. Very few of those infected accessed testing and treatment, especially in low- and middle-income countries.

On the last World Hepatitis Day in 2017, however, the World Health Organization (WHO) published information from 28 countries which show that, despite many challenges and major obstacles, the global effort to eliminate hepatitis is gaining ground.

HEPATITIS C - OVERCOMING THE CHALLENGE OF HEALING

Four years ago at SCOR, our medical team was sure HCV treatment would be considered as revolutionary and that has since become the case. The HCV infection, with hepatic or extrahepatic manifestations leading to chronic inflammation being mostly reversible, is the only chronic infection that can be cured. The significant morbidity and mortality related to HCV justifies its screening and access to treatments have significantly increased over the past two decades. Its treatment underscores the importance of strengthening screening and expanding access to care policies in the hopes to eliminate the viral C infection in the short term.

In countries that have access to advanced pharmaceutical treatments, SCOR's medical experts are seeing very efficient therapies that are simpler, well-tolerated by patients and with good results in a relatively short expected length of treatment, as foreseen in our 2014 paper. Discussions are also taking place on opportunities to screen the whole population instead of treating the costly consequences of the disease (source: Cousien et al.)

HEPATITIS B - NO CURE YET

The hepatitis B virus infection remains a global public health concern with approximately 254 million individuals becoming chronic HBsAg carriers worldwide The likelihood that viral infection becomes chronic depends upon the age at which a person becomes infected. The need for curative treatment also depends mainly on the stage of the disease.

Hepatitis B screening should be performed in all exposed individuals; vaccination should be implemented at birth or during early childhood and in individuals with risk factors. A vaccine against hepatitis B has been available since 1982. The vaccine is 95% effective in preventing infection and the development of chronic disease and liver cancer due to hepatitis B (source: WHO). China is currently conducting a major eradication plan to fight this major public health issue in China, affecting 7% of the Chinese population.

Hopes are there that Hepatitis B will gradually fade away and a cure will be found.

HEPATITIS E - BEWARE

Hepatitis E virus (HEV) infection is currently recognized as an endemic pathogen in developed countries, especially in Western Europe. In these regions, HEV is a zoonotic agent and is mainly transmitted by the consumption of undercooked pig meat.

In France for example, it concerns up to 100 000 cases. HEV infection is generally a self-limiting illness in immunocompetent subjects.

Recently, some extra-hepatic manifestations associated with HEV infection have been observed, suggesting a broader tropism than initially considered.

At SCOR, we will continue to monitor viral hepatitis, keep our eyes open for more news in this field and remain hopeful that global eradication efforts will pay off.

We are also looking very closely at other forms of liver diseases with our R&D Medical Director Dominique Lannes who is an expert on NASH. Non-alcoholic steatohepatitis is a silent, symptomless disease that insidiously degrades the liver. This form of hepatitis, in the absence of viruses and alcoholism, is linked solely to a very fatty diet, leading to cirrhosis and liver cancer with transplant being the only treatment option since there is currently no medication.