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Defeat the B and C viruses of hepatitis it’s possible. For the first there is a vaccine, for the second, thanks to specific drugs, it is possible to cure the infection and eradicate the virus, avoiding the onset of distant complications, potentially very serious. You just have to think about it and focus on the recognition of the pictures thanks to screening, which is done with a simple blood test.
Right on screeningHowever, one must aim to identify people who have developed C virus infection without any particular symptoms and do not know they have the virus. There is a long series of indications that the World Health Organization recalls on the occasion of World Hepatitis Day, scheduled for 28 July. The commitment to defeat these viruses is carried out by the infectious disease specialists of the SIMIT – Italian Society of Infectious and Tropical Diseases and by the hepatologists of the AISF – Italian Association for the Study of the Liver.
Why attention to viruses
The attention of clinicians is mainly directed to Hepatitis B and C, those with the most serious, sometimes lethal, effects. They are considered a threat to public health, as if they become chronic, they cause complications over time, including fatal ones, such as cirrhosis and liver cancer.
However, Hepatitis B can be prevented with the vaccine, while Hepatitis C can be treated with effective and resolving drugs, so much so that the WHO had set the goal of its elimination by 2030, a result made achievable thanks to new antiviral drugs with direct action, which allow the virus to be eradicated definitively, quickly and without side effects.
“The pandemic has slowed down Italy’s march towards the elimination of hepatitis C – highlights Massimo Andreoni, SIMIT Scientific Director – In February 2020, the government allocated 71.5 million euros to carry out screening among those born between 1969 and 1989, as well as between drug addicts and prisoners.
Some regions have already equipped themselves, others are refining the models. It is a commitment of primary importance, given that Hepatitis C is still highly endemic in Italy, with hundreds of thousands of people needing to be diagnosed. As for Hepatitis A and B, on the other hand, we have very valid vaccines available, which allow us to prevent infection. For hepatitis B in Italy the vaccine is usually administered around the age of 12; for Hepatitis A it must be done by people at risk. For the latter there are no drugs, while for hepatitis B the available therapies allow to control the infection, but not to eradicate it; vaccination therefore remains the main weapon “.
What happened in time of Covid-19
“The measures of containment and social distancing imposed by the pandemic have probably reduced, at least in industrialized countries, the spread of other infectious diseases, not only those transmitted by air, such as flu and colds, but also those transmitted sexually or by injecting or food, the latter for greater attention to hygiene.
The first data therefore indicate a decline also as regards the incidence of viral hepatitis which, if confirmed, would represent an important lesson to be taken into account also in the future, continuing the fight against these diseases – reports Massimo Galli, Past President of Simit and contact person for Hepatitis for the scientific society of Italian infectious diseases.
However, there are negative aspects associated with the pandemic whose consequences deserve careful consideration. Although complete data are not yet available regarding these last two years, it is likely that a decline in HBV vaccinations (hepatitis B virus) may have occurred and that it is therefore necessary to recover the missed vaccinations. On the other hand, the decline in hepatitis C treatments is sensationally evident, calling into question the possibility of achieving the goal of eliminating the disease set by the WHO for 2030.
This phenomenon, certainly accentuated by the pandemic, however, comes from further away and was already evident starting from 2018, as a consequence of the delay in interventions for the emergence of the submerged. Now it is crucial that we work in this direction, with an adequate use of the funds allocated in February 2020. It is also necessary to resume an effective work of sensitization in the population: recent experiences in which screening for Covid has been associated with that for Hepatitis C implemented in Lombardy demonstrate the persistence of a non-negligible number of HCV infections in people completely unaware of their condition “.
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