Stigma related to hepatitis B virus: A barrier to global viral hepatitis elimination

Chronic hepatitis B virus (HBV) infection remains a major global health challenge, affecting over 300 million people worldwide and contributing substantially to liver-related morbidity and mortality. Despite the availability of effective vaccination, diagnostic tools, antiviral therapy, and surveillance strategies, progress toward the World Health Organization's hepatitis elimination targets has been slower than anticipated. HBV-related stigma has emerged as a critical and under-recognized barrier undermining efforts across the entire HBV care cascade. Stigma associated with HBV is multi-faceted, encompassing internalized, social, systemic, and health care-related forms, and is driven largely by misconceptions surrounding transmission, moral judgment, and disease prognosis. These stigmatizing beliefs negatively impact testing uptake, disclosure, linkage to care, treatment adherence, and long-term surveillance while also contributing to psychosocial distress and reduced quality of life among people living with HBV. This narrative review synthesizes current literature on the manifestations and consequences of HBV-related stigma, examines its impact on global hepatitis elimination efforts, and highlights strategies to mitigate stigma through targeted education, culturally sensitive interventions, and health care provider training.