Global reporting of progress towards elimination of hepatitis B and hepatitis C

Background The 69th World Health Assembly endorsed the global health sector strategy on viral hepatitis to eliminate viral hepatitis as a public health threat by 2030. Achieving and measuring the 2030 targets requires a substantial increase in the capacity to test and treat viral hepatitis infections and a mechanism to monitor the progress of hepatitis elimination. This study aimed to identify the gaps in data availability or quality and create a new mechanism to monitor the progress of hepatitis elimination.Methods In 2020, using a questionnaire, we collected empirical, systematic, modelled, or surveyed data-reported by WHO country and WHO regional offices-on indicators of progress towards elimination of viral hepatitis, including burden of infection, incidence, mortality, and the cascade of care, and validated these data.Findings WHO received officially validated country-provided data from 130 countries or territories, and used partner-provided data for 70 countries or territories. We estimated that in 2019, globally, 295 center dot 9 million (3 center dot 8%) people were living with chronic hepatitis B virus (HBV) infection and 57 center dot 8 million (0 center dot 8%) people were living with chronic hepatitis C virus (HCV) infection. Globally, there were more than 3 center dot 0 million new infections with HBV and HCV and more than 1 center dot 1 million deaths due to the viruses in 2019. In 2019, 30 center dot 4 million (95% CI 24 center dot 3-38 center dot 0) individuals living with hepatitis B knew their infection status and 6 center dot 6 million (5 center dot 3-8 center dot 3) people diagnosed with hepatitis B received treatment. Among people with HCV infection, 15 center dot 2 million (95% CI 12 center dot 1-19 center dot 0) had been diagnosed between 2015 and 2019, and 9 center dot 4 million (7 center dot 5-11 center dot 7) people diagnosed with hepatitis C infection were treated with direct-acting antiviral drugs between 2015 and 2019. Interpretation There has been notable global progress towards hepatitis elimination. In 2019, 30 center dot 4 million (10 center dot 3%) people living with hepatitis B knew their infection status, which was slightly higher than in 2015 (22 center dot 0 million; 9 center dot 0%), and 6 center dot 6 million (22 center dot 7%) of those diagnosed with hepatitis B received treatment, compared with 1 center dot 7 million (8 center dot 0%) in 2015. Mortality from hepatitis C has declined since 2019, driven by an increase in HCV treatment ten times that of the strategy baseline. However, an estimated 89 center dot 7% of HBV infections and 78 center dot 6% of HCV infections remain undiagnosed. A new global strategy for 2022-30, based on these new estimates, should be implemented urgently to scale up the screening and treatment of viral hepatitis.

Automated summary

This study aimed to identify gaps in data availability or quality and create a new mechanism to monitor the progress of hepatitis elimination. The findings showed that globally, the number of people living with chronic hepatitis B and C infections is still high. The progress towards hepatitis elimination requires an increase in testing and treatment capacity, as well as monitoring of the elimination efforts.