World Hepatitis Day 2024

Despite considerable advances in diagnostics and therapeutics, including functional cures for both hepatitis B and C, and a hepatitis B vaccine, viral hepatitis was the second leading cause of death among communicable diseases in 2022. Chronic hepatitis can cause liver cirrhosis and cancer, thereby representing a significant healthcare burden.

The World Health Organisation’s (WHO) global hepatitis strategy aims to reduce new hepatitis infections by 90%, and deaths by 65% between 2016 and 2030 [1]. Global elimination of the hepatitis B virus (HBV) is predicted to yield a net economic benefit ~US $100 bn by 2050, with HCV elimination yielding a ~US $20 bn benefit by 2030 [2-4].  Considerable progress has been made in reducing the burden of hepatitis, with the UK, Australia, and Egypt leading global efforts. England have now met the WHO’s targets for elimination of HBV transmission from mother to child: a key milestone in its HBV elimination strategy [5]. Similarly, the UK Health Security Agency estimates that hepatitis C prevalence has fallen by 45% in England thanks to NHS England’s national elimination programme, with over 80,000 people treated since 2015 [6]. In Egypt, 50 million residents were screened for HCV, with 4 million undergoing treatment between 2014 and 2020 [7]. However, between 2019 and 2022, annual deaths from hepatitis increased from 1.1 million to 1.3 million, 83% of which were caused by hepatitis B. This increase has been attributed to various factors, including the reduction in access to diagnosis and treatment during the COVID pandemic, especially in low- and middle-income countries [2].

The WHO suggests current efforts will not achieve their 2030 goals; getting back on track could prevent 2.1 million cases of cancer and save 2.85 million lives [2]. Innovative, country-specific schemes targeting at-risk populations, such as prisoners, people who inject drugs, and men who have sex with men, will likely be key to the global effort to eliminate the burden of hepatitis [2]. Reducing barriers to diagnosis and treatment through testing and treatment via harm-reduction services is associated with increased treatment uptake [8]. In England, this has been achieved through various targeted schemes, including the High Intensity Test and Treat scheme in prisons, and order-to-home HCV testing kits [9,10].

As clinically relevant drug-resistant strains of hepatitis viruses emerge, treating more patients with hepatitis, in turn reducing their likelihood of transmission, may decrease the chance that these strains become a significant healthcare burden. Furthermore, increasing outreach to vulnerable, hard-to-reach populations will likely yield additional benefits, reducing the burden of other diseases, such as sexually transmitted infections.

HEOR has an established reputation for innovative approaches and technical excellence, including modelling cost-effectiveness of pharmaceutical interventions in hepatitis. Considering interventions in hepatitis within the context of changing populations, behaviours, and healthcare policies, and the effect on disease epidemiology, like transmission and resistance, may yield considerable value.