India's National Viral Hepatitis Control Program Overview

India's National Viral Hepatitis Control Program Overview

India is systematically working toward its 2030 goal of combating hepatitis through the National Viral Hepatitis Control Program (NVHCP), which adopts a health systems approach integrated with various national programs. The program provides preventive, promotive, and curative interventions including free drugs and diagnostics to people affected by viral hepatitis, covering all five hepatitis viruses (A, B, C, D, and E).

Disease Background and Transmission

Hepatitis is an inflammation of the liver caused by hepatitis viruses, other infections, toxic substances like alcohol and drugs, or autoimmune diseases. Hepatitis B and C are the most common types leading to chronic disease including cirrhosis and liver cancer. Transmission varies by type: Hepatitis A and E spread through faecal-oral route via contaminated food/water, while Hepatitis B, C, and D spread through contact with infected blood, blood products, body fluids, unsafe injections, and mother-to-child transmission.

Prevention and Treatment Approaches

The program employs different prevention and treatment strategies for each virus type. Hepatitis B is vaccine-preventable through the Universal Immunization Program, which provides birth dose within 24 hours and additional doses at 6, 10, and 14 weeks. Chronic Hepatitis B is managed with antiviral medication as per national guidelines. Hepatitis C has no vaccine but can be cured in 12-24 weeks using pan-genotypic regimen with Direct-Acting Antiviral (DAAs) drugs. Hepatitis D prevention is achieved through Hepatitis B vaccination, while Hepatitis A and E prevention focuses on safe drinking water, hygiene, and sanitation measures.

Program Integration and Services

The NVHCP integrates with multiple national health programs: Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition program provides universal screening of pregnant women for Hepatitis B; Universal Immunization Program ensures 100% hepatitis B birth dose to all newborns and Hepatitis B immunoglobulin to newborns of positive pregnant women; National AIDS Control Program screens high-risk groups for hepatitis B and C and provides vaccination to healthcare workers and screened negative high-risk groups; National Tuberculosis Elimination Program utilizes existing machines for molecular testing; and Blood Transfusion services link Hepatitis B/C positive donors for further management.

Epidemiological Data and Monitoring

According to 2021 HIV Sentinel Surveillance data, India's seroprevalence rates are approximately 0.85% for Hepatitis B (roughly 1 in 118 people) and 0.29% for Hepatitis C (roughly 1 in 345 people). The program uses a paperless system for recording and reporting through the NVHCP-MIS portal for patient management and monitoring. A toll-free number (1800-11-6666) shared with the NTEP provides general information about infection prevention, transmission modes, management, and service delivery sites across the country.

Program Implementation

Since its launch in 2018, the program has expanded services from district hospitals to local health centers using local funding, cheaper generic drugs, and existing health program infrastructure. Hepatitis A and E are monitored as acute, symptomatic, outbreak-prone diseases through the Integrated Disease Surveillance Program, while free diagnostics and drugs are provided for Hepatitis B and C management nationwide.