Requirements for global elimination of hepatitis B: a modelling study

Area of Science:

• Epidemiology
• Public Health
• Infectious Diseases

Background:

• Hepatitis B virus (HBV) infection remains a major global health threat, causing nearly one million deaths annually.
• Despite existing interventions, widespread transmission and inadequate treatment access hinder HBV control efforts.
• The World Health Organization (WHO) aims for global control and elimination of HBV infection.

Purpose of the Study:

• To evaluate the impact of public health interventions on the global HBV epidemic.
• To propose targets for reducing HBV incidence and mortality.
• To identify key developments necessary for HBV elimination.

Main Methods:

• Development of a global HBV epidemic simulation model.
• Incorporation of data on HBV natural history, prevalence, mortality, vaccination, treatment, and demographics.
• Estimation of the impact of current and scaled-up interventions, including screening and treatment.

Main Results:

• Infant and neonatal vaccination are significantly decreasing new HBV infections, averting millions of cases and deaths.
• Without scaled-up interventions, 63 million new chronic infections and 17 million deaths are projected between 2015-2030.
• Achieving 90% reduction in new infections and 65% in mortality requires scaling up vaccination, peripartum antivirals, and population-wide testing/treatment.
• These scaled-up interventions could avert 7.3 million deaths and reach elimination thresholds by 2090, with manageable costs.

Conclusions:

• Eliminating HBV as a public health threat necessitates scaling up vaccination, improving mother-to-child transmission prevention, and implementing ambitious population-wide testing and treatment.
• Achieving these targets will significantly contribute to the Sustainable Development Goals for combating hepatitis.
• Further innovations, including a potential cure, could accelerate HBV elimination efforts.