World Hepatitis Day: Advancements in Prevention, Screening, and Treatment

Significance of World Hepatitis Day

Every year on July 28th, World Hepatitis Day is observed, aligning with the birthday of the late Dr. Baruch Blumberg. Dr. Blumberg was instrumental in the research and prevention of hepatitis B, one of five viral hepatitis strains, which include hepatitis A, C, D, and E. These viruses can lead to liver inflammation, escalating to liver disease, liver failure, and potentially liver cancer. Hepatitis remains a significant global health issue, with approximately 325 million individuals living with hepatitis B or C, resulting in 1.4 million deaths annually. Alarmingly, nine out of ten people with viral hepatitis are unaware of their condition.

Global Campaign for Awareness and Action

World Hepatitis Day is a global public health initiative led by the World Health Organization (WHO) aimed at raising awareness and promoting action to eliminate viral hepatitis by 2030. The 2019 theme, “Invest in eliminating hepatitis,” calls on policymakers to allocate funds for hepatitis prevention, testing, and treatment services. The high mortality rates associated with hepatitis are partially due to low diagnostic rates, with the World Hepatitis Alliance reporting that 90% of those infected remain undiagnosed and untreated.

Innovations in Hepatitis Research

In recognition of World Hepatitis Day, Medical News Bulletin is highlighting recent advancements in hepatitis prevention, screening, and treatment. These innovations are pivotal for the goal of eradicating hepatitis as a public health threat by 2030.

Development of Hepatitis C Vaccines

Although effective vaccines for hepatitis A and B are available, creating a vaccine for hepatitis C has proven difficult due to the virus’s genetic variability. Current research is focused on developing vaccines that stimulate the immune system to produce protective antibodies or T-cells. Many experimental HCV vaccines in early clinical trials utilize T cell-mediated immunity. A notable study from 2014 demonstrated that an adenovirus-based HCV vaccine was well-tolerated and successfully induced a T-cell response.

Advancements in Screening Technologies

Traditionally, diagnosing hepatitis required blood samples and laboratory tests for viral antigens or antibodies. Recent advancements in rapid diagnostic technologies are streamlining hepatitis screening. Point-of-care assays allow individuals to be tested and receive results during the same visit. Innovations in point-of-care testing are utilizing more accessible sample types, such as finger-prick blood or oral fluids. An example is the OraQuick HCV Rapid Antibody Test, which has shown effectiveness in hepatitis C screening during outbreak investigations.

New Oral Treatments for Hepatitis

Untreated hepatitis B and C can lead to chronic conditions, necessitating new medications to eliminate the virus. Historically, hepatitis C treatment relied on interferon-based therapies, which, despite their efficacy, were often poorly tolerated and associated with significant side effects. The introduction of direct-acting antiviral agents (DAAs) in 2011 marked a breakthrough, offering safer and more effective oral treatment options with shorter regimens. A 2018 study in Italy reported a 93% cure rate among HCV patients treated with DAAs. Continued advancements have led to second-generation drugs, such as Epclusa (sofosbuvir/velpatasvir), which are effective against all hepatitis C virus genotypes.

Conclusion: A Global Approach to Hepatitis

With emerging hepatitis vaccine candidates, improved point-of-care testing, and innovative treatment strategies, the groundwork is being laid to tackle viral hepatitis on a global scale. The commitment to advancing research and public health initiatives is critical for addressing this pressing health challenge.

Written by Cheryl Xia, HBMSc

References

1. World Hepatitis Day 2019. World Health Organization. Available at: https://www.who.int/campaigns/world-hepatitis-day/2019.
2. Taylor, B. 290 MILLION WORLDWIDE UNAWARE THEY ARE LIVING WITH DEADLY VIRUS. World Hepatitis Alliance (2018). Available at: http://www.worldhepatitisalliance.org/news/jul-2018/290-million-worldwide-unaware-they-are-living-deadly-virus.
3. McConnell, M. & Lim, J. K. Hepatitis C Vaccine Development in the Era of Direct‐Acting Antivirals. Clinical Liver Disease 12, 118–121 (2018).
4. Swadling, L. et al. A human vaccine strategy based on chimpanzee adenoviral and MVA vectors that primes, boosts, and sustains functional HCV-specific T cell memory. Science Translational Medicine 6, 261ra153-261ra153 (2014).
5. Gao, F. et al. Performance of the OraQuick HCV Rapid Antibody Test for Screening Exposed Patients in a Hepatitis C Outbreak Investigation. Journal of Clinical Microbiology 52, 2650–2652 (2014).
6. Zając, M. et al. Hepatitis C – New drugs and treatment prospects. European Journal of Medicinal Chemistry 165, 225–249 (2019).
7. Calvaruso, V. et al. Incidence of Hepatocellular Carcinoma in Patients With HCV-Associated Cirrhosis Treated With Direct-Acting Antiviral Agents. Gastroenterology 155, 411-421.e4 (2018).
8. Chahine, E. B., Sucher, A. J. & Hemstreet, B. A. Sofosbuvir/Velpatasvir: The First Pangenotypic Direct-Acting Antiviral Combination for Hepatitis C. Ann Pharmacother 51, 44–53 (2017).