‘More needs to be done’ to reach 2030 goals to eliminate HBV

According to a presenter at The Liver Meeting Digital Experience, diagnosis and treatment for hepatitis B virus remains low; therefore, significant increases in treatment are needed to decrease disease burden.

“It's going to take a lot of work for us to globally meet the WHO 2030 targets,” Devin Razavi-Shearer, HBV/HDV project lead at the Center for Disease Analysis Foundation, said during the presentation. “To achieve these goals, we need to ensure the governments increase access to screening and treatment. Part of this will be our job as professionals in pressuring them to make these changes that will greatly improve the lives of the global population and our fellow country people.”

“Currently the guidelines are so many diagnostic tests and follow up appointments that it may be difficult for many of these countries to implement them,” Razavi-Shearer added. “We will decide if we're going to focus on treating those most at risk of liver disease, or fully treat hepatitis B as the public health problem that it is and truly work to eliminate it.”

Models on HBV disease burden

Razavi-Shearer and colleagues used results of a literature review and Delphi expert interviews to develop country-specific PRoGReSs models, an HBV disease burden and transmission Markov model. There were models developed for 166 countries, of which 94 received feedback from country experts. The remaining 40 were based on published data and 32 used extrapolated prevalence data.

When available, investigators collected diagnosis data from national registry. Razavi-Shearer and colleagues collected treatment data from country reports. Additionally, they collected sales data for HBV medication. They consulted country experts to validate findings from collected grey literature. Regional averages were applied to the total population of the country when data was unavailable.

Increase in HBV treatment needed

At the start of 2020, the global prevalence of HBV was estimated to be 3.63%, which was 279.9 infections. Shearer noted only 13% or 36.7 million were estimated to have been diagnosed with HBV, of which 2.9 million were diagnosed in 2019 alone. Out of the diagnosed patients, 6.6 million were estimated to be on anti-viral treatment, according to Razavi-Shearer.

Razavi-Shearer said 90% of all HBV treated cases were found in eight countries.

According to Razavi-Shearer, 0.8% of 5-year-old patients were estimated to be infected with HBV. Of these, 67% occurred in Africa. Additionally, 90% of infections among patients aged 5 years are found in lower middle- and low-income countries.

“Now we really are able to see the disparities in the prevention of mother to child and early childhood transmission, Razavi-Shearer said.

Razavi-Shearer said experts needs to find more innovative solutions to treat more infected women who are pregnant, “to ensure that the future generations face a much lower disease burden of hepatitis B than those that our generation have faced.”