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Challenges for hepatitis B control in Asia-Pacific areas: Consolidating vaccination and rolling-out antiviral
Pei-Jer Chen1,2,3
1Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan.
Insights
Chronic hepatitis B (CHB) control requires ongoing efforts. Strategies include monitoring vaccine efficacy, strengthening vaccination programs, expanding antiviral use, and developing new curative therapies to meet global health goals.
Area of Science:
- Hepatology and Viral Hepatitis Research
- Public Health and Epidemiology
- Infectious Disease Control
Background:
- Chronic hepatitis B (CHB) remains a significant global health challenge, particularly in the Asia-Pacific region.
- While vaccination and antiviral therapies have reduced prevalence from 4.2% to 3.2% (1980-2020), substantial progress is still needed to meet 2030 WHO Sustainable Development Goals (SDG).
Purpose of the Study:
- To review current strategies and propose future directions for achieving WHO SDG targets for CHB control.
- To highlight the need for continued efforts in prevention, treatment, and cure of CHB.
Main Methods:
- This review synthesizes data on CHB prevalence, treatment outcomes, and global control initiatives.
- It analyzes four key areas for future action: vaccine efficacy monitoring, vaccination program enhancement, expanded antiviral therapy, and development of curative treatments.
Main Results:
- Global CHB prevalence has decreased, and long-term antiviral therapy improves patient outcomes.
- Significant challenges persist in achieving the ambitious 2030 WHO targets for CHB incidence and mortality reduction.
Conclusions:
- Achieving CHB control requires a multi-faceted approach including sustained public health interventions and advancements in therapeutic strategies.
- Continued societal commitment to monitoring, prevention, treatment, and cure is essential for eradicating CHB.
Abstract:
Chronic hepatitis B (CHB) was, and still is, a prevalent liver disease in the world, especially high in the Asia-Pacific areas. With the advent of preventive vaccines and effective viral suppression drugs and active implementations, CHB has gradually become under control. The world-wide prevalence reduces from 4.2% in 1980 to 3.2% in 2020 study. CHB patients receiving long-term antiviral therapies significantly improve the clinical outcomes, saving from end-stage liver diseases. Despite of these impressive progresses, to meet the WHO sustained development goals (SDG) for CHB control, a 90% reduction of incidence and a 65% reduction of mortality in year 2030, there is still a long way to go. In this review, four ongoing approaches have been proposed: (i) A continuous monitoring of long-term vaccine efficacy in vaccinated populations; (ii) consolidating the hepatitis B virus vaccination program against vaccine hesitancy and limited resources; (iii) rolling-out current oral antivirals to more CHB patients not only for diseases treatment but also for infection preventions; and (iv) development of curative therapies, both friendly-to-dispense and affordable. A coherent and persevere efforts by the society may succeed and achieve the SDG for CHB in the future.
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