In Asia Pacific, deaths from hepatitis three times higher than AIDS/HIV

In the Asia-Pacific region, considered the biggest and densest part of the world, deaths from viral hepatitis each year are three times higher than those of HIV/AIDS, a study said.

“Despite the escalating death toll from viral hepatitis, governments have often been at a loss about how to tackle these diseases, lacking the technical expertise, resources and even evidence to justify the investments needed to confront viral hepatitis,” said Dr. Jose Sollano, Jr., gastroenterologist and member of Coalition to Eradicate Viral Hepatitis in Asia Pacific (CEVHAP) in the Philippines.

Sollano made the statement during a media roundtable discussion on hepatitis on Thursday in Greenhills.

CEVHAP, Hepatitis Society of the Philippines (HSP), and global pharmaceutical company MSD are raising awareness about the hepatitis situation in the Philippines in time for World Hepatitis Day on July 28.

“We now have the evidence that justifies the investment in the form of one million people dying needlessly every year.  We also have a new framework from the World Health Organization and as a member of CEVHAP, I urge our policymakers to form national strategies and ensure viral hepatitis receives the attention it needs,” Sollano said.

Data from the the United States-based independent research center Institute for Health Metrics and Evaluation said there are approximately one million deaths from hepatitis every year compared to 300,000 from HIV/AIDS.

Meanwhile, the article "Hepatitis B Infection among Adults in the Philippines: A national seroprevalence study" posted on the World Journal of Hepatology's April 2013 issue said
16.7% of Filipinos are infected with Hepatitis B.
 
What is hepatitis?
 
According to the World Health Organization (WHO), hepatitis is a "silent epidemic" and
"millions of people are living with viral hepatitis and millions more are at risk of becoming infected."

"Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. There are five main hepatitis viruses, referred to as types A, B, C, D and E," WHO said.

WHO said most people with chronic infection with hepatitis B or C are "unaware that they continue to carry the virus. They are therefore at high risk of developing severe chronic liver disease and can unknowingly transmit the virus to other people."

WHO Data show that about one million people die each year from causes related to viral hepatitis, most commonly cirrhosis and liver cancer.

Vaccination: Key to preventing spread of disease

CEVHAP said vaccination is key in preventing the spread and ideally, this should be administered to infants, children, and even teenagers.
 
Sollano lamented that the number of people availing of hepatitis vaccination in the Philippines is low.

Often, the three vaccinations needed -- the second taking place one month after the first and the third doses given six months after the second -- are not completed, Sollano noted.

He also mentioned that the completion rate in private hospitals is actually lower than in public hospitals.

The medical staff in public hospitals also have undergone more training and are receiving more incentives for promoting hepatitis vaccines, he said.
 
"The government does not really notice or emphasize Hepatitis B [in particular]," said Dr. Sollano."
 
"The number of children born every year is already calculated beforehand," he said. "Hindi nagkukulang yung DOH sa pagbili nang mga hepatitis vaccines. Kaso lang, madalas hindi sila na-aadminister."


'Preventable, misunderstood'
 
Hepatitis types B and C are very common in the Philippines-- but only type B has a prevention vaccine as of now.
 
"Hepatitis is one of the most underrated and misunderstood diseases," said Sollano. "People don't want to out themselves, but at the same time, they should be hungry for information, as hepatitis is a treatable, preventable disease."
 
When free checkups are given at barangays and health centers, Sollano said people who already have themselves checked regularly are usually also the ones who avail of the barangay checkups.
 
Sollano noted that some people refuse to have themselves checked because they fear the prognosis.
 
Financial reasons

Sollano noted that some people claim that the lack of financial means prevents them from having themselves checked for hepatitis.

However,  Sollano relayed a joke told by some American colleagues of his: that Filipinos should be raring to be vaccinated, as the vaccine is cheaper than the pirated DVDs. One dose is less than a hundred pesos.
 
There are two options for adults who contract the disease elsewhere: a vaccine administered for an entire year, and tablets taken for as long as five to seven years.
 
"But at the end of the day, pareho lang yung ginastos mo sa injection," he said. "It is also possible for the disease to develop immunity to the pills--when that happens, bibigyan ka ng additional pills to the ones you're already taking."
 
Dr. Sollano also said Philhealth is currently considering reimbursing payments for treatment of hepatitis C.
 
Lifestyle changes
 
Meanwhile, Sollano recommended some lifestyle changes to help people avoid contracting hepatitis.
 
"You really have to exercise," said Sollano. "Fat and obesity attacks the liver. Alcohol kills the liver, too. Daily intake or in binges is still bad. Where the frustration in the country is high, the alcohol intake is also high--the Philippines and India are examples of this."
 
When asked who were the most at risk for hepatitis, Sollano responded, "drug addicts."
 
"Especially when they use injections," he said. "They often change the needles but do not throw out the syringes. If you have any friends who like to, you know, like to do this, you must urge them strongly to stop."
 
Sollano also said the evidence for liver-protecting supplements, food supplements, and detoxification methods were shaky at best.
 
World Hepatitis Day

On July 28, the celebration of World Hepatitis Day in the Philippines will focus on disease education and screening for early detection and treatment.

HSP will conduct its annual screening, free consultations as well as lay fora at Cardinal Santos Medical Center in San Juan.

MSD has also partnered with several hospitals in conducting free  hepatitis C screenings and lay fora on

• July 17 and 24: Vicente Sotto Memorial Medical Center in Cebu,
• July 19: Philippine General Hospital,
• July 26: National Kidney and Transplant Institute,
• July 27: Davao Doctors Hospital, and
• July 28: Cardinal Santos Medical Center.

For World Hepatitis Day, the Liver Society is also planning to fly balloons for the cause and attempt to break the Guinness record for this.
 
"Hepatitis is an expansive disease to have," said Sollano. "But what disease isn't? People do not save for things they do not expect to happen to them, but I urge them to save for future possible illnesses."

In November, there will be a big gathering in Cebu about liver cancer, one of the complications of hepatitis, in the Asia-Pacific region. - VVP/ELR GMA News