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Infectious Diseases

The Plan to Prevent, Treat, and Eliminate Hepatitis B and Hepatitis D

More than 257 million worldwide people suffer from chronic hepatitis B, an inflammation of the liver that’s caused by infection of the hepatitis B virus.

Hepatitis B, the most common liver infection in the world, is caused by the hepatitis B virus (HBV). It’s transmitted through direct contact with infected bodily fluids, including blood and semen, or during pregnancy.

People with chronic HBV infection can develop serious liver damage or liver cancer, which can cause premature death. Every year, almost one million people die from this chronic infectious disease, which is more than deaths from hepatitis C, HIV/AIDS, or malaria.

Diagnosis, treatment, and prevention

The condition is diagnosed by a blood test. Chronic hepatitis B may be treated with pegylated interferon alpha, or with pills called nucleoside or nucleotide analogues.

The best way to prevent hepatitis B is to get vaccinated. Over a billion doses of the hepatitis B vaccine have been administered in the past 40 years. The vaccine has been shown to be effective in approximately 95 percent of cases.

Hepatitis D

Globally, HDV affects nearly 5-10 percent of people who have chronic hepatitis B virus infection. This co-infection is considered the most severe form of chronic viral hepatitis due to more rapid progression towards liver-related death and hepatocellular carcinoma. There is currently no approved treatment that can cure HDV co-infection.

The vaccine against hepatitis B is important, too, because it is the only way to prevent hepatitis D (HDV infection), which needs HBV for its replication.

Mongolia, the Republic of Moldova, and countries in Western and Middle Africa are considered HDV hot spots. In Mongolia, 15 percent of all of the country’s deaths are caused by hepatitis. However, recent analysis indicates that HDV co-infection is found in 11.8 percent of people with HBV infection in the United States. 

Public health goals

The sustained efforts to vaccinate everyone globally against hepatitis B, which also prevents hepatitis D, are promising.

A World Health Organization (WHO) study estimates that with hepatitis B vaccination, diagnostic tests, medicines, and education campaigns, 4.5 million premature deaths could be prevented in low- and middle-income countries by 2030. WHO’s global hepatitis strategy, which is endorsed by all WHO Member States, aims to reduce new hepatitis infections by 90 percent, deaths by 65 percent, and increase treatment to 80 percent between 2016 and 2030.

The success of this strategy will depend not only on these vaccination efforts, but improving the diagnosis and treatment of chronic HBV and HDV with existing therapies, as well as new therapies able to cure existing HBV and HDV infection.

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