World Hepatitis Day - July 28th 2023
World Hepatitis Day takes places every year on the 28th July with the aim of bringing the world together under a single theme to raise awareness of the global burden of viral hepatitis and to influence real change. The theme of World Hepatitis Day 2023 is “We’re not waiting” https://www.worldhepatitisday.org/.
Ireland has committed to the WHO target of eliminating viral hepatitis as a major public health concern by 2030.
Hepatitis B and C
Chronic hepatitis B and C are life-threatening infectious diseases that can cause serious liver damage, liver cancer, and premature death. It is estimated that more than 350 million people are infected with the hepatitis B or the hepatitis C virus worldwide. In Ireland, cumulatively to the end of 2022, almost 17,000 cases of hepatitis C and over 13,000 cases of hepatitis B had been notified to the HSE Health Protection Surveillance Centre (HPSC). Hepatitis B and C notifications declined during the COVID-19 pandemic, but returned to pre-pandemic levels in 2022. During the year 2022, 480 cases of hepatitis C and 515 cases of hepatitis B were reported.
In developed countries, like Ireland, hepatitis C is most commonly transmitted through sharing contaminated equipment when injecting drugs or through receipt of unscreened blood or blood products in the past. Sexual, occupational and mother to baby transmission can also occur but are less common. Two thirds of cases notified in Ireland between 2007 and 2022 were people who inject drugs, 11% of cases were born in an endemic country (risk factor not reported), 6% were sexually acquired and 3% had received blood or blood products in the past.
The most common modes of transmission for hepatitis B are mother to baby transmission at birth, unprotected sex and sharing needles when injecting drugs. In recent years, over 95% of people notified with hepatitis B in Ireland were chronically infected cases, most of whom were born in countries with a higher hepatitis B prevalence and were likely to have been infected at birth or in early childhood. The number of acute cases of hepatitis B (new infections) notified each year in Ireland is low; on average 16 cases were reported annually over the past five years. Most are sexually acquired.
National hepatitis C treatment programme
A national hepatitis C treatment programme (NHCTP) was established by the HSE in 2015 with the aim of providing treatment to all people living with hepatitis C in Ireland (https://www.hse.ie/eng/national-hepatitis-c-treatment-programme/). Over 7,000 patients have been successfully treated since 2015.
Hepatitis B vaccination
There is a safe and effective vaccine for hepatitis B. This was added to the primary childhood immunisation schedule in Ireland in October 2008 for children born from July 1st 2008. Hepatitis B immunisation is also recommended for risk groups, babies born to hepatitis B positive mothers and household and sexual contacts of cases.
Elimination of viral hepatitis is achievable
With the availability of effective vaccines and treatments for long-term suppression of hepatitis B, and highly effective curative treatments for hepatitis C, elimination of viral hepatitis is now achievable. However, chronic hepatitis B and C infections can be asymptomatic or mildly symptomatic for years, or even decades, after infection. This means that without screening, some people may not be diagnosed until they have already developed considerable liver damage and may also have unintentionally infected others.
Over 220,000 hepatitis B and over 200,000 hepatitis C tests were carried out in Ireland in 2022. In spite of extensive testing there are likely to be some undiagnosed cases. With continued efforts in screening and retention in care, it remains possible that hepatitis B and C will no longer be a major public health concern in Ireland by 2030.
Further information on hepatitis C:
https://www.hpsc.ie/a-z/hepatitis/hepatitisc/
https://www.hse.ie/eng/national-hepatitis-c-treatment-programme/
https://www.hpsc.ie/a-z/hepatitis/hepatitisc/factsheetleaflets/hpsc.ie/a-z/hepatitis/injectingdrugusers/publications/Drug-related%20bloodborne%20viruses%20in%20Ireland,%202018.pdf
Further information on hepatitis B:
http://www.hpsc.ie/a-z/hepatitis/hepatitisb/factsheetsleaflets/
https://www.hpsc.ie/a-z/hepatitis/hepatitisb/surveillancereports/