WHO Classifies Hepatitis D as Cancerous Virus
The World Health Organisation (WHO) has recently reclassified hepatitis D as a carcinogenic virus. This decision marks the urgent need to prevent viral hepatitis, which remains global health challenge. Hepatitis D virus (HDV) infection, especially when combined with hepatitis B virus (HBV), greatly increases the risk of liver cancer and severe liver disease. This reclassification is expected to boost worldwide efforts in surveillance, research, and prevention.
Hepatitis Types
Hepatitis refers to liver inflammation caused by viruses, toxins, or autoimmune diseases. The five main viral types are A, B, C, D, and E.
- Hepatitis A spreads via faecal-oral route and causes acute infection. Vaccines are available.
- Hepatitis B spreads through blood and bodily fluids and causes chronic infection. Vaccines exist.
- Hepatitis C transmits mainly through blood exposure and has no vaccine.
- Hepatitis D infects only those with hepatitis B and worsens outcomes.
- Hepatitis E spreads through contaminated water and food; vaccines are limited.
Hepatitis D and Its Cancerous Nature
Hepatitis D is a defective virus that requires the presence of hepatitis B virus to replicate. It cannot infect individuals alone. Co-infection or superinfection with HBV causes more severe liver damage. Studies show HDV increases liver cancer risk two to six times compared to HBV alone. Around 75% of HDV patients develop liver cirrhosis within 15 years. HDV intensifies the carcinogenic effect of hepatitis B, which itself can cause cancer by integrating into liver cell DNA.
Modes of Transmission
Hepatitis D spreads similarly to hepatitis B and C. Transmission occurs through blood and bodily fluids. This includes unsafe injections, blood transfusions, mother-to-child transmission, and unprotected sexual contact. High-risk groups include intravenous drug users and those with chronic hepatitis B. Preventive measures such as safe blood practices and barrier contraception are essential.
Diagnosis and Prevention
Diagnosis of hepatitis D involves blood tests detecting HDV RNA or antibodies. Since HDV depends on HBV, universal hepatitis B vaccination indirectly prevents hepatitis D infection. Despite inclusion in national immunisation programmes, hepatitis B vaccine coverage remains low in many regions. Safe injection practices, screening of blood products, and safe sex education are critical preventive strategies. Emerging antiviral treatments like bulevirtide offer hope for managing chronic HDV infection.
Hepatitis B Vaccination Schedules
Hepatitis B vaccine is given in multiple schedules depending on age and risk. Common regimens include doses at birth, 6 weeks, and 14 weeks or at birth, 1 month, and 6 months. Adults at high risk require three doses spaced over six months. Vaccination is the most effective method to prevent HBV and consequently HDV infection.
Public Health Implications
The carcinogenic classification of hepatitis D calls for intensified global health action. It stresses the importance of vaccination, safe medical practices, and public education. Enhanced funding and research are needed to reduce the burden of HDV-related liver cancer and improve treatment options.
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