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LETTER TO THE EDITOR Table of Contents  
Ahead of print publication
Ensuring strengthening and expansion of the prevention and control activities for the elimination of hepatitis C

1 Vice Principal Curriculum, Department of Community Medicine, Member of the Medical Education Unit & Medical Research Unit, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

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Date of Submission08-Aug-2018
Date of Acceptance06-Oct-2018
Date of Web Publication03-Dec-2018

How to cite this URL:
Shrivastava SR, Shrivastava PS. Ensuring strengthening and expansion of the prevention and control activities for the elimination of hepatitis C. Libyan Int Med Univ J [Epub ahead of print] [cited 2019 Jun 19]. Available from: http://journal.limu.edu.ly/preprintarticle.asp?id=246794

Dear Editor,

Hepatitis C is a liver disease of viral origin and the patients can present with either acute or chronic forms of the disease.[1] On an average, 30% of the patients will have an acute infection, which will clear itself without any treatment, while the remaining 70% of patients will present with chronic and lifelong illness.[1],[2] The global estimates suggest that more than 70 million people have chronic infection and that each year close to 0.4 million people dies due to the resulting complications of cirrhosis or liver cancer.[3]

Considering that no vaccine is available for preventing the disease, it becomes very essential to ensure that the available medicines reach to all those who are in need of the same as the drugs can resolve more than 95% of the infections.[1],[3] The available global estimates depict that close to 2.86 million people received the treatment for the infection in the last couple of years.[3],[4] However, if the global stakeholders want to achieve the target of elimination of the disease by 2030, at least four-fifths of the infected patients should receive the treatment.[4]

The analysis of the prevention and control activities has led to the identification of various challenges, which all have to be addressed promptly by the stakeholders.[1],[3] The first and foremost challenge is lack of adequate funding owing to which all the key activities take a back seat.[2],[4] From the diagnostic perspective, only 20% of people are aware of their infection status, and there is an immense need for the nations to formulate policies and initiate programs to not only increase the awareness of the general population but also the number of diagnostic facilities.[3] Even on the treatment front, the access to therapy is low, either due to the high cost of the therapy or poor awareness or lack of availability.[1],[3]

Further, there is an immense need to ensure the provision of a comprehensive package of preventive services (namely primary prevention by minimizing the risk of exposure to the infection both in healthcare settings and among high-risk population groups, and secondary and tertiary prevention by strengthening the components of education and counseling on treatment modalities, promotion of regular monitoring for the early detection of chronic liver disease), but then we are falling short even in this regard.[1],[4] The failure on this front is the main reason for the detection of more than 1.7 million new cases each year worldwide.[3],[4]

To ensure the movement in the right direction, there is a definitive need to adopt innovative approaches.[1] In fact, there is a need for the development of more effective point-of-care diagnostic tools and innovative preventive strategies.[1],[3] Furthermore, inputs should be given in the research area for the development of vaccine.[1] Further, the guidelines for carrying out screening (to diagnose new cases and to detect the development of chronic stage), care of infected people (counseling to decrease alcohol intake and assessment for the degree of liver fibrosis/cirrhosis), and treatment with direct-acting antivirals should be strictly adhered by all the national governments and the health professionals.[5],[6]

To conclude, hepatitis C is a major global public health concern, requiring prompt attention. Thus, there is a definitive need to strengthen and expand the available prevention and control strategies to successfully eliminate the disease within the set timeframe.

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Conflicts of interest

There are no conflicts of interest.

  References Top

World Health Organization. Hepatitis C-Fact sheet No. 164. World Health Organization; 2017. Available from: http://www.who.int/mediacentre/factsheets/fs164/en/. [Last accessed on 2018 Aug 08].  Back to cited text no. 1
Shrivastava SR, Shrivastava PS, Ramasamy J. Strategic implementation of the global strategy for the containment of the viral hepatitis infections. J Curr Res Sci Med 2017;3:64-5.  Back to cited text no. 2
  [Full text]  
World Health Organization. Global Hepatitis Report, 2017. Geneva: WHO Press; 2017. p. 1-13.  Back to cited text no. 3
World Health Organization. Close to 3 Million People Access Hepatitis C Cure. World Health Organization; 2017. Available from: http://www.who.int/mediacentre/news/releases/2017/hepatitis-c-cure/en/. [Last accessed on 2018 Aug 09].  Back to cited text no. 4
World Health Organization. Guidelines for the Screening, Care and Treatment of Persons with Chronic Hepatitis C Infection. Geneva: WHO Press; 2016. p. 1-26.  Back to cited text no. 5
Shrivastava SR, Shrivastava PS, Ramasamy J. Advocating for the implementation of the updated guidelines for the management of hepatitis C infection universally. Ann Trop Med Public Health 2017;10:311-2.  Back to cited text no. 6
  [Full text]  

Correspondence Address:
Saurabh RamBihariLal Shrivastava,
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur, Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/LIUJ.LIUJ_36_18


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