2024 latest report on hepatitis B virus epidemiology in China: current status, changing trajectory, and challenges

Hepatitis B virus (HBV) infection is a significant global public health concern, particularly in China, which accounts for one-third of the world's chronic HBV cases. Over the past three decades, China has made substantial progress in controlling HBV infection. Currently, the vaccination rate of the three-dose hepatitis B vaccine in China has risen to 99.6%, and the coverage of timely birth dose has reached 95.6%, significantly exceeding the global average level. The recent edition of chronic hepatitis B (CHB) prevention and treatment guideline has further expanded the treatment population to allow 94% of CHB patients meet the treatment criteria. With the complete immunization for newborns, in combination with antiviral treatment for HBV infected pregnant women, the mother-to-child transmission (MTCT) rate in China has decreased to 0.23%. The prevalence of hepatitis B surface antigen (HBsAg) has significantly declined to 5.86% in the general Chinese population. Specifically, among children under five years old, HBsAg prevalence showed the most significant reduction, from 9.67% in 1992 to 0.30% in 2020. However, challenges remain in achieving the World Health Organization (WHO)'s 2030 targets. In 2020, only 58.78% of HBV-positive individuals in China were aware of their status and 17.33% received antiviral therapy. The burden of HBV-related complications such as liver cirrhosis and hepatocellular carcinoma persists despite declining HBV infection rates. In this review, we analyzed the current status and evolving trajectory of HBV prevention and control in China, utilizing the latest data from national surveys, the Chinese Center for Disease Control and Prevention, and the WHO's 2024 report. We summarized the progress made, highlighted disparities, and outlined the persistent challenges and opportunities for HBV elimination. We recommend that future efforts focus on maintaining strict control of mother-to-child and bloodborne transmission, expanding screening strategies, improving early accessibility and diagnostic rates, addressing regional healthcare disparities, enhancing treatment accessibility and coverage, and ensuring timely antiviral therapy to ultimately achieve elimination goals.