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Why do just one percent of HBV-positive Indians receive treatment?

Hepatitis B. Copyright: <a href=''>jarun011 / 123RF Stock Photo</a>Just five countries account for 57 percent of the world’s cases of hepatitis B virus (HBV). India is one of them.

Almost 292 million people worldwide have HBV. Of these, just five percent receive the treatment they need. Ninety percent are undiagnosed, according to a study published earlier this year in The Lancet. The study drew on a plethora of data to produce a comprehensive estimation of HBV infection rates worldwide.

The study estimates there to be 3.27 million people in India who test positive for HBsAg, the surface antigen which indicates current HBV infection. However, just 519,000 have been diagnosed.

9.175 million Indians are eligible for HBV treatment, the study adds. However, just 4,700 – less than one percent of those eligible – are receiving it.

‘A significant public health problem’

India’s burden of HBV has long been a concern. A study published last year said that ‘hepatitis B is a significant public health problem in India, yet disease awareness is very low among the general population.’ As such, it continued, ‘most patients present in the advanced stage.’

The Indian government has yet to implement a nationwide screening and referral programme for hepatitis B or hepatitis C. As such, India is most likely going to miss the global target of eliminating hepatitis by 2030. Experts say, with government action, the objective can be achieved by 2080.

The HBV vaccine, which provides effective coverage against the disease, is included as part of the Centre’s National Immunisation Programme. However, its provision needs to be expanded. The Lancet study says coverage with a full course of HBV vaccination is just two percent.

The need in India is for increased education, vaccination coverage and access to treatment for the chronically infected, especially for new mothers. As the Lancet study shows, there is a lot of work left for India to do.

The study in The Lancet can be accessed here.

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