COVID‐19 and viral hepatitis elimination programs: Are we stepping backward?
Hamidreza Karimi‐Sari, Mohammad Saeid Rezaee‐Zavareh
Abstract
As Mendlowitz et al mentioned in a recent article,1 the World Health Organization set a goal for the elimination of viral hepatitis until 2030. This means that the number of newly infected persons and related mortality should be decreased by 90% and 65% respectively. The elimination programs focus on different parts such as testing, treatment, immunization against hepatitis B virus (HBV), preventing mother to child transmission, blood safety, and harm reduction.2 Now, COVID-19 is spreading fast throughout the world and more than one million people have been affected by this virus so far. While all attentions are now on providing effective medicines and vaccines for COVID-19, we should not forget other viruses and diseases.3 Although COVID-19 seems to not affect some parts of the elimination program such as HBV vaccination, preventing mother to child transmission and blood safety, some other parts can severely be influenced by this infection. Quarantine and social distancing for COVID-19 can affect diagnosis, treatment and harm reduction programs. Increasing people’s awareness plays an important role in viral hepatitis elimination programs as it leads to more case finding.4 Hence, the diagnosis rate seems to be reduced by decreasing voluntary activities like the NoHep program.4 Moreover, the incidence of viral hepatitis may be increased by the probable closing of harm reduction centres.5 Furthermore, the treatment of patients with viral hepatitis can be influenced by closing private clinics and decreasing the number of non-emergent visits. Primary care settings and GPs, which have an essential role in hepatitis elimination,1, 6 are now focusing on the COVID-19 pandemic and this change can reduce both diagnosis and treatment rates of hepatitis patients. Besides, published hepatitis-related research in PubMed (using the search term of “Hepatitis[tiab]” search time: 20/04/20) in the first 3 months of 2019 (n = 3763) compared to the same period in 2020 (n = 2808) shows a reduction by 955 documents. This may verify our idea about the impact of COVID-19 on viral hepatitis elimination programs. Today, we are fighting with an important public health threat, COVID-19, which certainly needs special attention. But we should be more careful about our previous public health achievements. If we cannot have progress about them these days, at least we should keep them at their current situation and avoid stepping backward to reach the goal of viral hepatitis elimination by 2030.