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ICMR soon to begin research on 'Viral hepatitis in India'
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Ramesh Shankar, Mumbai
January 09 , 2018
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As the burden of hepatitis is increasing in the country, necessitating
focus on prevention and control measures to mitigate the morbidity and
mortality, the Indian Council of Medical Research (ICMR) will soon begin
research on 'Viral hepatitis in India'.
The priority areas of
research included lab monitoring/strengthening for real time data inflow
and feedback for automated report generation using modern technology;
and rapid or molecular technology utilization for capacity building and
hands-on training of laboratory staff at various levels to perform
molecular assays and use of molecular technology in understanding the
distribution/clustering of strains/circulating genotypes/serotypes.
In
the operational research, the research will focus on disease burden
studies (epidemiology, transmission dynamics and risk factors) for viral
hepatitis with special focus on HEV; to understand viral/host
components leading to severity during pregnancy for Hepatitis E;
identify barriers for low immunization coverage for Hep B in India;
studies to understand the impact of immunization of Hep B over years;
develop point-of-care diagnostics (for bedside use) with good
sensitivity and specificity; multi-centric screening of blood and stool
samples from organ transplant patients to know HEV chronicity; field
testing / clinical trials of new interventions (drugs/vaccines); to
analyse HBV vaccine response in HIV infected individuals; comparison of
indigenous and Chinese HEV vaccines in clinical trials; understanding
efficacy of alternative medicine in preventing/treating viral hepatitis;
assessment of utility and cost effectiveness studies of NAT with
routine ELISA in blood banks in HBV, HCV and HIV among blood donors;
estimating the cost-effectiveness of RUP syringes; and understanding
modes of transmission of viral hepatitis B in local settings.
In
the area of prevention, the focus will be on to assess re-infection
rates in Hep B and Hep C; to assess SVR in re-infection rates; to
develop interventions to prevent re-infections; develop monitoring
systems for adherence to DAAs; studies to identify effective approaches
for partner testing; to identify effective approaches for adherence to
treatment in different risk groups; and to assess incidence of hepatitis
A among men having sex with men.
The ICMR's initiative is
significant as viral hepatitis is increasingly being recognized as a
public health problem, having epidemic proportions that cause 1.34
million deaths each year. In India, the estimated burden of hepatitis is
very high, necessitating focus on prevention and control measures of
hepatitis to mitigate the morbidity and mortality due to hepatitis.
Amongst the reported causes of mortality amongst communicable diseases
in India in 2015, viral hepatitis accounted for 3% of total. There is
however, a paucity of nationally representative data to establish
accurate disease burden. New infections caused by the five known
hepatitis viruses – A, B, C, D and E (HAV, HBV, HCV, HDV and HEV) – can
be prevented. In addition, testing and treatment can improve the health
of persons with chronic infections. The sequel to chronic hepatitis
includes cirrhosis and hepato-cellular carcinoma that pose long term
burden on the health system.
India is committed to achieve the
SDGs and the SDG 3.1 aims to achieve the elimination of viral hepatitis
by 2030. The Government of India is a signatory to this WHA resolution
and the country’s vision is to move towards elimination of Viral
Hepatitis by 2030. With this background, a comprehensive integrated 3
year National Action Plan for Viral Hepatitis (NAPVH) is being developed
by MoH&FW, Govt. of India, with the key objective to provide an
actionable framework of evidence based, priority interventions to
support the national response for prevention, control and management of
viral hepatitis in the country.
In view of the above and
existing gaps in current programmes, it is pertinent to address all
aspects under the Integrated National Programme on Prevention and
Control Programme for Viral hepatitis, of which research and innovation
is one important component. It is proposed to enhance knowledge and
skills required for evidence base on various aspects of the epidemic,
up-scaled operational research, cross-cutting, multi-disciplinary
themes, improved research quality, better research capabilities and
expanded partnerships, utilization and management of research based
knowledge on viral hepatitis, relevant measurable and context specific
indicators for tracking the epidemic and assessing impact. The program
will focus more on operational programmatic research that could feed
into planning and policy decision.
The research proposals can be submitted by January 15, 2018.
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