Viral hepatitis remains difficult to control worldwide

Despite breakthroughs in the treatment and prevention of hepatitis B (HBV) and hepatitis C (HCV) in recent decades, the 2030 elimination target set by the World Health Organization (WHO) has still not been achieved worldwide.

Viral hepatitis attacks the liver, which acts as the body's filter. It can lead to cirrhosis (scarring of the liver), liver cancer, liver transplantation, and death. The most common hepatitis viruses are transmitted through contaminated food and water (hepatitis A) and through shared needles and sex (hepatitis B and C). Effective vaccines are available against hepatitis A and B. In addition, HCV is curable in most cases, whereas HBV is not.

Although experts noted a brief dip in the number of hepatitis deaths worldwide, the number has now risen from 1.1 million in 2019 to 1.3 million in 2022, according to Vox. Together, HCV and HBV are responsible for about 3,500 deaths worldwide each day. Only 11 countries are on track to eradicate HCV by 2030, and none are expected to eradicate HBV in that time frame.

According to experts, stigma and lack of government action in developing countries are partly responsible for the consistent number of new HCV and HBV cases worldwide.

“If current trends continue, by 2040 the number of people dying from hepatitis B and C will exceed the number of people dying from HIV worldwide. [tuberculosis] and malaria,” Andrea Cox, MD, PhD, who specializes in infectious diseases, including hepatitis, at Johns Hopkins University, told Vox.

Experts report that countries in Africa and South Asia have the highest burden of viral hepatitis due to inadequate health systems and stigma. In fact, more than 60% of all new HBC infections occur in Africa, yet only 18% of newborns there are vaccinated against the virus, according to Vox.

Stigma and prejudice against people with hepatitis often arise from ignorance about hepatitis and how it is transmitted. This can have a negative impact on the personal and professional life as well as the mental health of those affected. Stigma can also prevent people from getting tested for hepatitis and seeking medical treatment when needed, and can limit their opportunities to work, study or travel.

Experts point out that a lack of knowledge about hepatitis may lead to a decrease in the willingness of medical professionals and government officials to proactively contain the disease.

“If a family is known to have hepatitis B, they are really avoided in many parts of the world,” Chari Cohen, MPH, DrPH, president of the Hepatitis B Foundation, told Vox. “I wouldn't want to get tested if I lived in a country and knew that if I tested positive, I would lose my job.”

In fact, a recent study found that almost half of all Europeans living with HBV or HCV do not share their diagnosis with others due to stigma. Four in 10 people with HCV and one in six people with HBV reported that they avoid seeking healthcare when they need it due to fear of discrimination and stigma.

Cohen stresses that the global hepatitis community must mobilize and demand action from governments to achieve hepatitis elimination goals.

“I felt like after 25 years I didn't have to keep arguing about priorities. I thought it would be a no-brainer,” Cohen said. “But the communities most affected by hepatitis B are the disenfranchised communities, the communities that don't typically have a political voice. They don't have political power. And if you don't demand action, you won't get it.”

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