World Hepatitis Day
World Hepatitis Day is one of the global health campaigns earmarked by World Health Organization to be observed on July 28 every year. It aims to raise global awareness of hepatitis and encourage prevention, diagnosis and treatment. Hepatitidies (Plural; of Hepatitis) are a group of infectious diseases known as Hepatitis A, B, C, D, and E. They affect hundreds of millions of people worldwide, causing acute (A and E) and chronic (B,C and D) disease and killing close to 1.34 million people every year. In some countries Hepatitis B & C are the commonest causes of cirrhosis and can also cause liver cancer (HCC). PSSLD makes every effort to highlight this day in Pakistan by holding seminars and conferences all over Pakistan on this day and requesting dignitaries and health policy makers to attend and chair these sessions.About 15 million people in Pakistan live with hepatitis B or C, with the overwhelming majority unaware of their disease and lack the knowledge about how the viral infection can be prevented, treated, and, in the case of Hepatitis C, cured. Pakistan Society for the Study of Liver Diseases (PSSLD) organized a series of webinars to observe World Hepatitis Day. The prevalence of hepatitis B in Pakistan is around 2.5%, while that of hepatitis C is 5%. But the prevalence is much higher than average in some districts of upper Sindh, Punjab, and Balochistan. About 300 people die in Pakistan every day due to complications caused by hepatitis, a much higher fatality rate than the current Covid-19 pandemic in Pakistan. Dr. Zaigham Abbas, President PSSLD, who heads the Department of Hepato-Gastroenterology Ziauddin University Hospital, Karachi moderated a first-of-its-kind webinar organized by PSSLD in association with Express Media Group. The participants of this webinar included Dr. Bashir Ahmed from Shaheed Mohatarma Benazir Bhutto Medical University Larkana, Dr.Shahid Rasool, Madina Teaching Hospital, Faisalabad, Dr. Adil Naseer Khan Ayub Medical College Abbottabad, Dr. Muhammad Salih Consultant Hepatologist Quaid-e-Azam International Hospital Islamabad, Dr. Masood Siddiq Jinnah Memorial Hospital Rawapindi, Dr. Amna Subhan Aga Khan University (AKU), Dr. Saeed Hamid, head of the Clinical Trials Unit at the AKU and Dr. Wasim Jafri (AKU). The speakers talked about risk factors, mother to child transmission, vaccination, medical complications caused by hepatitis and how they are treated, how screening can be carried out to identify the millions who have the virus but are yet to be diagnosed.“We need commitment and concerted action from the government instead of patchy responses. Covid-19 has further complicated the situation and the program for mass screening is likely to be delayed further”, speakers observed. They also urged the media to play their role in creating awareness about the disease. The webinar, which was broadcast live on social media, and well covered by electronic and print media also included questions from viewers, which the speakers answered following their presentations. In another webinar on ‘Play your role in the elimination of hepatitis’, speakers discussed the role of primary care physician, hepatologist, infection control personnel, NGOs, and government authorities in the hepatitis elimination efforts. The theme of the 3 rd webinar was ‘Don’t let COVID-19 undermine hepatitis elimination efforts’. The webinar was addressed by Dr. Zaigham Abbas, Dr. Muzaffar Gill, Dr. Ghias Un Nabi Tayyab, Dr. Sadik Memon, and Dr. Bakht Biland. Dr. Zaigham Abbas answer to the questions of lay public in a webinar in Urdu ‘Our liver, our responsibility’. Besides, Dr. Sadik Memon, and Dr. Qazi Masroor and other members of PSSLD organized mini-symposia in Hyderabad and Bahawalpur and other cities of Pakistan. Dr. Saeed Hamid and Dr. Zaigham Abbas participated in the international webinars to observe WHD.
World Hepatitis Day-2020Report by: Dr. Zaigham Abbas
The Gut-Liver Axis
Pakistan Society for the Study of Liver Diseases (PSSLD) organized a webinar on 30th May in collaboration with WGO to commemorate WDHD 2020. The title of the webinar was "The Gut Liver Axis". Prof. Saeed Hamid, from Aga Khan University Hospital, Karachi, Pakistan who is also Chair, Hepatology Interest Group WGO, moderated the Webinar. Prof. Zaigham Abbas from the Ziauddin University Karachi and current President of PSSLD, gave the first presentation on the topic. Several factors affect the development and alteration of the gut microbiome including birthing and infant feeding method, exposure to physical, metabolic, and psychological stress, environment, diet, medications, and stage of the lifecycle, and comorbid diseases.
The interaction of gut with the host is mostly indirect and is mediated by their metabolic products, also called postbiotics, "The Gut-Liver Axis is a bidirectional relationship between the gut microbiota and the liver. This reciprocal interaction is established by the portal vein which transports gut-derived products directly to the liver and the liver feedback route of bile and antibody secretion to the intestine", Dr. Abbas added. Prof. Wasim Jafri, from Aga Khan University and Director WGO Karachi Training Center introduced the next key speaker, Prof. Eamonn Quigley. Professor Quigley is Co- Chair, WDHD 2020 Campaign. He spoke on 'Gut Microbiome and Liver Disease’ and mentioned vascular, lymphatic, and liver firewalls that captures gut bacteria entering the blood stream. He also shed light on the role of gut microbiota in chronic liver disease, hepatic encephalopathy, acute liver injury, hepatocellular carcinoma, primary sclerosing cholangitis, and non-alcoholic and alcoholic fatty liver disease. Professor Masood Siddiq, former president PSSLD introduced the next speaker, Professor Jasmohan Bajaj. He is a member of the WDHD 2020 Steering Committee. He discussed 'Therapies Targeting the Gut-Liver Axis' and concluded that microbiota can be managed in several ways to benefit liver disease. This online seminar had a good turnout of participants from different parts of the world.