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WHO launches first ever global hepatitis report

AMSTERDAM — While progress has been made in the global burden of hepatitis, there is still much to be done to achieve eradication by 2030, according to WHO, which released its first ever global hepatitis report at the International Liver Congress.

“We are in the era of elimination,” Gottfried Hirnschall, MD, MPH, director of department of HIV and global hepatitis program, WHO, said during a press conference. “The hepatitis train has left the station. ... We still have a long way to go. We have to push forward and push forward dynamically. And we have to do it together.”

Hirnschall explained that this inaugural report focuses on HBV and HCV because these comprise 96% of mortality from hepatitis.

The report outlines that there are 257 million living with hepatitis B, 68% of which reside in Africa and the Western Pacific regions. Hirnschall showed that vaccinations in HBV increased sharply and, on a global level, 84% of children received the three-part vaccination in 2015. The report states that the proportion of children younger than age 5 years with new infections fell from 4.7% in the pre-vaccine era to 1.3% in 2015.

“Only half of the countries are providing the birth dose,” Ana Maria Henao-Restrepo, MD, medical officer, department of immunization vaccines and biologicals, WHO, said, pointing to this as a concerning source of eventual chronic HBV.

In HCV, the report outlines that there are 71 million people infected with HCV and still waiting to be treated with 1.75 million new HCV infections per year.

“We are making a dent every year ... but we still have more new infections than we can cure every year so we still have an epidemic,” Yvan J.F. Hutin, MD, PhD, Technical Officer in charge of Strategic Information at the Global Hepatitis Programme, WHO, said.

In the cascade of care, the report outlines that only 9% of the 257 million people with HBV are actually diagnosed and only 1.7 million were on treatment in 2015. In HCV, 20% of the 71 million with HCV are also diagnosed and just 1.1 million started treatment in 2015.

Additionally, Hirnschall said the number of deaths from hepatitis continues to increase, with 1.34 million deaths in 2015.

“More and more people are still dying from hepatitis. The numbers are still going up,” Hirnschall said. “We have a major public health issue ... that still needs to be addressed.”

In his general session presentation of the report, Hutin outlined the report’s call for increased harm reduction strategies such as needle syringe distribution, better point of care tests and financing elimination of hepatitis through universal health coverage.

“We have all the tools we need to eliminate hepatitis. We could go further with innovation,” Hutin said in the presentation. “The 2015 baseline calls for immediate and sustained action. The global picture is taking shape but many countries still lack the data they need for action. We have a gap in prevention, but we also need a major scale-up of testing and treatment that increases access and reduces inequity. The quest for a sustainable solution should lead us to universal health coverage.”

Hirnschall said about 40 countries have developed elimination of hepatitis plans with more underway.

“We will continue to measure the progress and publish reports that demonstrate the progress we would like to see,” he said. – by Katrina Altersitz

References:

Hutin YJH. WHO launch of the first ever global hepatitis report. Presented at: International Liver Congress; April 19-24, 2017; Amsterdam.

Hirnschall G. Press Conference. Presented at: International Liver Congress; April 19-24, 2017; Amsterdam.

Disclosures: Hirnschall, Henao-Restrepo and Hutin report no relevant financial disclosures.