Hepatitis workshop throws up scary numbers for Nagaland

KOHIMA, SEPTEMBER 21: A state-level workshop on Hepatitis-B and Hepatitis-C virus (HBV and HCV) was conducted today in the conference hall of the directorate of Health and Family Welfare in Kohima town. The event was conducted with officials of the Health department.
It was informed that as per the Integrated Bio-Behavioral Assessment (IBBA) study among Intravenous Drug Users (IDUs) in 2006 and 2009, the prevalence of HCV among IDUs in Phek stood at 5.4% (2006) to 8.7% (2009) and 16.7% (2006) to 20.8% (2006) in Wokha, respectively, which underlined an expanding HCV epidemic in the state of Nagaland.
Noting the lack of much knowledge on HBV and HCV among the people of the state, secretary for Health and Family Welfare, Maongwati Aier, addressed the workshop as the guest of honour. He emphasized on the need for the department to create awareness on the topic of HBV and HCV.
The official also suggested that ‘this kind of workshop needs to be conducted at the district level and also at the community- and public health centre levels across the state.’
Also, sharing his concern on the alarming rate of HCV infection as was being recorded in some studies conducted in Nagaland, Aier pointed out that the rate was as high as 30% among IDUs as per the investigation carried out by the Regional Medical Research Centre of ICMR located in Dibrugarh, National AIDS Research Institute, Pune and Kripa Foundation in 2005.
Expressing deep concern in this regard, Aier strongly suggested that the message has to reach the macro level, and that the participants should become master trainers and conduct Training of Trainers (TOTs) to facilitate dissemination of information as widely as possible.
On HBV vaccination, he maintained that it has to be made available at all Health settings and also to population groups who are most at risk.
Dr Samiran Panda, from NICED (ICMR) and Dr Saubhik Ghosh from the Calcutta Medical College were the resource persons for the event. They spoke about transmission, ‘disease burdens,’ and clinical aspects of HBV and HCV, and ‘disease burden’, diagnosis and treatment, among others.
Dr Panda discussed in details about the transmission dynamics of both the viruses and highlighted that while HBV is a DNA virus, HCV has RNA at its core. He further drove the points home that while HBV vaccine is available, no such vaccine against HCV is yet in the market.
Dr Ghosh in his presentation spoke on different Genotypes of both the viruses and implications of them with regard to disease course as well as treatment. He also informed the participants about the various types of management and treatment modalities that are currently available. Regarding treatment of HCV, he said the era of Pegylated Interferon is phasing out with the coming in of new Directly Acting Antivirals (DAAs) like Sofosbuvir in combination with Ledipasvir or Daclatasvir.
These combination therapies, he said have shown cure rates ranging from 86% to 100% depending on the HCV genotypes and far greater chance of attaining Sustained Virological Response (SVR) compared to the Pegylated Interferon based therapy.
Representing Pharmaceutical companies, Sanjay Roy from Abbott and Pranab Kumar Sarma fromZ ydus Heptiza deliberated on the facilities available offer under HCV treatment packages in Nagaland. They also discussed about the currently available screening and treatment facilities in the State, and how they could join hands with various stakeholders to boost it up.
They both have shared their enthusiasm to work with the Government of Nagaland to address the disease burden of HCV in the state.
Meanwhile during the way forward discussion hour, it was recommended that the Health Department, needs to follow up with National AIDS Control Organization as well as the Ministry of Health, Government of India, on launching of Hepatitis prevention and treatment programs in the State.
It was also recommended that the State Government need to put up an official correspondence seeking the intervention of the Ministry of Health, Government of India to facilitate operational research with the support from the Department of Health Research and involvement of Indian Council of Medical Research generate information on disease burden as well as impact of HCV treatment on the quality of lives of people living with HCV.
The participants have also suggested that NHM proposes Hepatitis Program in their AAP, the need to have a nodal officer for addressing HBV and HCV issues in the State, and that the Pharmaceutical companies need to provide their facilities of testing, screening, and impart skill and capacity enhancement programs to the Health Dept officials at the district level through a memorandum of agreement.
Dr L Watrikala, principal director of the Health & Family Welfare department presided over the program. Local nongovernmental organization, the Kripa Foundation-Project Sunrise, in collaboration with the state’s Health department, the Nagaland State AIDS Control Society and another NGO, the FHI 360, jointly organized the event.