Dr. Md Ayub Al Mamun: Today is the World Hepatitis Day being observed all over the world aiming to focus on different aspects of different types of hepatitis virus infection, to create awareness regarding preventive modalities & treatment options among the population and thus aiming to curtail the disease burden.

Main agenda of this year 2021 hepatitis day – Hepatitis cannot wait
Hepatitis & its perspective:
Hepatitis is defined as inflammatory disease of liver parenchymal cells, may be acute or chronic & may be caused by mainly hepatotropic viruses like A, E, B & C, drugs and other infections.
Today’s main focus is on the discussion of hepatotropic viruses.
Hepatitis E & A infections are usually water and food borne & usually causes acute hepatitis, they are usually self-limiting they may be prevented by improving food hygiene & drinking safe water.
Hepatitis B infection may cause either acute or chronic hepatitis and C infection causes chronic hepatitis usually.
Among these viruses, Hepatitis B virus infection is our main concern because we are falling in the intermediate prevalence zone (5-8%), Hepatitis C virus infection has a less prevalence 0.2-1%.
The major routes of transmission of this infection is salon saving, haircut, body piercing, Iv drug abuse, blood transfusion, sexual intercourse etc.
Hepatitis virus infection have been in our flesh and blood from time immemorial. Now a day’s hepatitis B virus infection is considered to be a major health problem with about 2 billion people are estimated to be affected and around 240 million chronic carriers, of this a significant number passes into chronic hepatitis, cirrhosis and HCC.
Disease Burden:
Once a person is infected by hepatitis virus he is prone to pass into compensated, decompensated cirrhosis, Hepatocellular carcinoma and may develop complications like hepatic encephalopathy, hepatorenal syndrome SBP and may succumb to death at any stage. Usually the patient develops different types of morbidities during the natural course of his disease, may be unable to take self-care and become others care dependent. This entails a great hardship on the family. Besides financial burden related to treatment cost, other family members are to get involved in the patient’s management with consequence of their work hour loss and also psychological burden. Thus entire family become involved to pay for the diseased person.
Cumulating these, there appears a huge impact of financial, social burden as a whole on the country. About 10-15% hospital admission in medicine ward is reported to be due to liver related diseases.
How to get relief:
Considering the routes, transmission of Hepatitis E, A may be prevented by safe drinking water, maintaining food hygiene. Hepatitis B & C virus transmission may be prevented by avoiding Iv drug abuse, ensuring safe blood transfusion avoiding saloon etc. Infected persons in the society may be detected by mass screening at large, ensuring screening every patient before surgery, in pregnancy and also screening at risk persons like Iv drug abusers frequently & etc. We may use different drugs to treat the disease, to prevent the complications and to arrest progression. This will help ensure better quality of the patient’s life and better healthy family life.
Beside we may promote vaccination of target risk population like contact person of HBsAg carrier, I/V drug abusers, neonates etc. We have a good impression that the current EPI vaccination programme has created a tremendous effect in curtailing the incidence of hepatitis B.
Thus we have ways not to get infected, have weapons to fight the disease once we are infected.
World Health Organization’s Proposition & Activities:
The World Health Organization has observed this grave impact of hepatitis infection and has identified that taking measures to prevent getting infection and making arrangement to treat the infected person may have a great impact to reduce the toll related to the diseases.
Thus message of this day is to aware the population in general to take measures not to get into the clutches of the disease and to strike consciousness among the infected persons to go under the shade of treatment umbrella.
To make the programme successful we should arrange meeting, seminar, symposium, rally etc. Various printing medias and Radio Television other social connecting should come forward to highlight different aspects of this disease to strike their awareness.

The success of the day depends on how effectively we may ventilate the information to the nook and corner of the country and to all and sundry beneath the sun.
Conclusion:
In conclusion we are interested to say that we are fighting against an infectious problem, so we are sure to win in the long run.
Upon these activities we hope & expect that we will be able to follow the right path to reach our destiny- elimination of hepatitis B & C by 2030.

Author: Dr. Md Ayub Al Mamun is the Chairman (BSMMU) of Department of Hepatology at Bangabandhu Sheikh Mujib Medical University (BSMMU). He can be reached at Gmail: ayubmamunal@gmail.com