Is the end of viral hepatitis near?

In 2021, the U.S. Department of Health and Human Services (DHHS) released the National Strategic Plan for Viral Hepatitis: A Roadmap for Eradication. With a vision of a world free of viral hepatitis, the Centers for Disease Control and Prevention’s (CDC) Viral Hepatitis Section works to eradicate these viral hepatitis epidemics through public health practice and research.

By 2025, the plan has four key objectives: reduce new viral hepatitis infections, reduce its morbidity and mortality, and address disparities related to the status of socioculturally vulnerable groups, while enhancing public surveillance through health strategies.

At the end of April this year, the Puerto Rico Department of Health shared the draft “Puerto Rico Viral Hepatitis Elimination Plan” on its website. Led by government agencies and nonprofits (among others), it proposes to replicate the program developed by DHHS, with the same goals.

The goals are extraordinary, say two experts in gastroenterology and liver transplantation who are optimistic about the possibility of eradicating viral hepatitis.

opinion based on actual evidence

For example, Dr. Iván Antunez González, who has practiced for two decades as a gastroenterologist and liver transplant specialist, is exposed to a form of viral hepatitis that is not treated early patients with the condition, for the following reasons: In his view, it has to do with the stigma that the disease still carries.

For experts, this is one of the most difficult misconceptions to dispel.

“I’m very concerned that any viral hepatitis is still considered to be due to you being an injecting drug user or engaging in high-risk (sexual) behaviour. So it has to be constantly clarified that many people who get the virus don’t necessarily have that behaviour. “, he emphasized. The expert emphasized the importance of capturing more people born between 1945 and 1965 (baby boomers), because it is a high-risk group.

Doctors called it another myth to focus on the cause of exposure to the virus.

“When confronted with a diagnosis — which is always strong — looking for why or how it happened doesn’t solve the problem. With the support of your doctor, it’s crucial to assume this and know that there are other ways to remove it — Especially in the case of hepatitis C. You also have to educate,” he emphasizes.

Another myth highlighted by Antunez-Gonzalez is the belief that these conditions cannot be cured or treated. Hepatitis A and B are preventable with vaccines, according to the CDC and Department of Health and Human Services; eradication of hepatitis C is now possible with an innovative therapy that eliminates the virus within eight to 12 weeks . “This is a great achievement that opens up new possibilities for those who have suffered,” he stressed.

In the case of Dr. Rafael Pastrana Laborde, also a gastroenterologist and liver transplant specialist, he has directed the specialty facility since its opening in 2011 The Liver Transplantation Center of the Auxilio Mutuo Hospital in Río Piedras.

According to Pastrana Laborde, the eradication program has been going on for several years, but according to him, there is still a lot of ignorance about viral hepatitis.

“Hepatitis B is actually curable,” says the expert. “After two months of treatment, 97% of patients cleared their disease. Now, it is important to understand that there are tools to reduce risk and, in cases of exposure, we can help eradicate risk, as the Federal Department of Health has done since the past 10 years. have been proposed for years,” he explained.

An important reality highlighted by Pastrana Laborde is that treatment for viral hepatitis is included in health care reform plans. “They have a greater advantage for patients who are co-infected with HIV. Generally, they are not the patients we see in the population because many of them receive clinical care services through the Ryan White program, So they receive more specialized treatment, which works to their advantage,” he explained.

One of the myths cited by Pastrana Laborde, like Antunez González, has to do with bias and misinformation. “A lot of times, people are afraid to talk about these topics because it’s still about certain lifestyles. So it’s important to continue to have an open conversation about this topic,” he explained.

On the other hand, the reality for this specialist is that for this very reason, many patients who are eligible for transplant due to liver damage do not complete the procedure because they have already developed more serious complications. “While our numbers are very good compared to the U.S. average, the reality is that only four in 10 patients make it through the transplant process. Unfortunately, this happens because they’ve been very complicated and died — This is the most difficult part of our practice,” he admits.

However, experts stress that the number of liver transplants due to viral hepatitis has dropped dramatically. “I would say that now we are transplanting more fatty liver patients (than hepatitis patients)”he pointed out.

hopeful future

For Antunes and Laborde, the DHHS initiative (which DS also endorses) proposes eradicating viral hepatitis in the not-too-distant future.

“We have the tools, the treatments work, and if we step up education and effective prevention, there’s no reason this program can’t be successful”Antunes Gonzalez is over.

“Viral hepatitis testing should be done at least once in a lifetime,” emphasizes Pastrana-Labord. He concluded: “Hopefully these messages will continue to be more publicized and we will support these initiatives.”

The author is a staff reporter for Saludable, Puerto Rico.