2023-12-07 02:48:17
There are five types of viral hepatitis, called A to E. Not all of them concern Reunion, except hepatitis B, C and D.Unlike other countries in the Indian Ocean region, Reunion is an area with a low prevalence of hepatitis C, half as present as in France.“, specifies Dr Laurent Cuissard, gastroenterologist at CHOR. Good news, the risk of contamination is therefore low. “SAccording to data collected by the Hepatitis Expert Center, a large proportion of hepatitis C cases have already been detected. But we would like to be able to treat everyone to make this pathology completely disappear. To do this, we must screen those who have never been screened. How many are left, it’s hard to know“, he adds. For him, we must move away from the cliché of the “syringe addict”, a rare practice in Reunion. This being said, Sniffing, on the rise on the island, is a significant risk factor. However, this screening concerns more widely people over 50, and in particular women who may have been infected during childbirth.
Benefits to know
“Hepatitis C is not only a liver pathology, it is also systemic. Two to three times more heart attacks, strokes, diabetes and neurocognitive disorders have been observed in infected patients and these extra-hepatic disorders can appear long following infection.“, adds Professor Pol.
According to recent data, he explains, treatment of the infection makes it possible to reduce all of these manifestations and also mortality. Moreover, “by restoring the immunity of treated subjects, we reduce chronic inflammation linked to the infection. This is very important on an individual level and on a collective level, among populations at risk, because it reduces dissemination.” But, he explains, in the case of cancer patients infected with hepatitis C, priority is often given to the main pathology without taking care of the hepatitis. “However, when we do this, we see an improvement in the cancer and a reduction in cancer recurrence. In more targeted populations, suffering from psychological disorders, we have even observed an improvement in general condition, both non-psychological and psychiatric, and a reduction in the number of hospitalizations. All these benefits were not necessarily known until now“.
Prevent hepatitis B
Hepatitis B, for its part, is a chronic disease. But she can be warned. “We have had effective vaccination since the 1980s, but the vaccination coverage rate, until the obligation put in place in 2018 for infants, is very insufficient. While we can eradicate the disease with the vaccine. This is what was done in Mayotte in the 1990s: the infection rate in the population was 6.5%, like in the Comoros, so strong prevention was needed. We therefore systematically screened and vaccinated pregnant women and newborns and injected babies with HB immunoglobulin from birth to prevent transmission. It was extremely effective.” For the moment, there is no question of a cure but there are major international issues surrounding drugs under development. “I am not necessarily a fan of this concept but if there are results, in my opinion, for the moment, it does not really replace what we already have“, estimates the specialist.
To avoid the D
Hepatitis B, like HIV, can be complicated by encountering the hepatitis D virus. The best prevention is therefore vaccination once morest hepatitis B. “Hepatitis D is a inflammation of the liver caused by HDV, which requires HBV to replicate, whether co-infection or superinfection. There cannot be hepatitis D in the absence of HBV.” specifies Professor Pol. “You must therefore always look for D when you have a positive B serology, but, currently, this is not systematically done“, underlines Dr Laurent Cuissard. This is one of the messages that Professor Stanislas Pol came to convey to the medical community. Especially since D can lead to cirrhosis or fulminant hepatitis (serious hepatitis associated with encephalopathy, Editor’s note), with an unfavorable prognosis.
As for hepatitis A and E, the first does not concern Reunion, although it is present in Madagascar, and the second is extremely rare on the island: “C“It’s a shame that the type A vaccine is not 100% reimbursed, but for Reunion Islanders traveling to the Indian Ocean area and Africa, it is recommended.” concludes Professor Stanislas Pol.
Mireille Legait
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