TY - JOUR
T1 - Global prevalence, cascade of care, and prophylaxis coverage of hepatitis B in 2022
T2 - a modelling study
AU - Razavi-Shearer, Devin M.
AU - Gamkrelidze, Ivane
AU - Pan, Calvin Q.
AU - Jia, Jidong
AU - Berg, Thomas
AU - Gray, Richard T.
AU - Lim, Young-Suk
AU - Chen, Chien-Jen
AU - Ocama, Ponsiano
AU - Desalegn, Hailemichael
AU - Abbas, Zaigham
AU - Abdallah, Ayat R.
AU - Aghemo, Alessio
AU - Ahmadbekova, Sabohat
AU - Ahn, Sang Hoon
AU - Aho, Inka
AU - Akarca, Ulus S.
AU - Al Masri, Nasser M.
AU - Alalwan, Abduljaleel M.
AU - Alavian, Seyed M.
AU - Al-Busafi, Said A.
AU - Aleman, Soo
AU - Alfaleh, Faleh Z.
AU - Alghamdi, Abdullah S.
AU - Al-Hamoudi, Waleed K.
AU - Aljumah, Abdulrahman A.
AU - Al-Naamani, Khalid
AU - Al-Rifai, Ahmad
AU - AlSerkal, Yousif M.
AU - Altraif, Ibrahim H.
AU - Amarsanaa, Jazag
AU - Anderson, Motswedi
AU - Andersson, Monique
AU - Armstrong, Paige
AU - Asselah, Tarik
AU - Athanasakis, Kostas
AU - Baatarkhuu, Oidov
AU - Ben-Ari, Ziv
AU - Bensalem, Aicha
AU - Bessone, Fernando
AU - Biondi, Mia J.
AU - Bizri, Abdul Rahman N.
AU - Blach, Sarah
AU - Braga, Wornei S. M.
AU - Brandao-Mello, Carlos E.
AU - Brosgart, Carol L.
AU - Brown, Kimberly A.
AU - Jr, Robert S. Brown
AU - Bruggmann, Philip
AU - Brunetto, Maurizia R.
AU - Et al.
AU - de Figueiredo Ribeiro, Sofia
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Background The 2016 World Health Assembly endorsed the elimination of hepatitis B virus (HBV) infection as a public health threat by 2030; existing therapies and prophylaxis measures make such elimination feasible, even in the absence of a virological cure. We aimed to estimate the national, regional, and global prevalence of HBV in the general population and among children aged 5 years and younger, as well as the rates of diagnosis, treatment, prophylaxis, and the future burden globally.Methods In this modelling study, we used a Delphi process with data from literature reviews and interviews with country experts to quantify the prevalence, diagnosis, treatment, and prevention measures for HBV infection. The PRoGReSs Model, a dyn amic Markov model, was used to estimate the country, regional, and global prevalence of HBV infection in 2022, and the effects of treatment and prevention on disease burden. The future incidence of morbidity and mortality in the absence of additional interventions was also estimated at the global level.Findings We developed models for 170 countries which resulted in an estimated global prevalence of HBV infection in 2022 of 3.2% (95% uncertainty interval 2.7-4.0), corresponding to 257.5 million (216.6-316.4) individuals positive for HBsAg. Of these individuals, 36.0 million were diagnosed, and only 6.8 million of the estimated 83.3 million eligible for treatment were on treatment. The prevalence among children aged 5 years or younger was estimated to be 0.7% (0.6-1.0), corresponding to 5.6 million (4.5-7.8) children with HBV infection. Based on the most recent data, 85% of infants received three-dose HBV vaccination before 1 year of age, 46% had received a timely birth dose of vaccine, and 14% received hepatitis B immunoglobulin along with the full vaccination regimen. 3% of mothers with a high HBV viral load received antiviral treatment to reduce mother-to-child transmission.Interpretation As 2030 approaches, the elimination targets remain out of reach for many countries under the current frameworks. Although prevention measures have had the most success, there is a need to increase these efforts and to increase diagnosis and treatment to work towards the elimination goals.
AB - Background The 2016 World Health Assembly endorsed the elimination of hepatitis B virus (HBV) infection as a public health threat by 2030; existing therapies and prophylaxis measures make such elimination feasible, even in the absence of a virological cure. We aimed to estimate the national, regional, and global prevalence of HBV in the general population and among children aged 5 years and younger, as well as the rates of diagnosis, treatment, prophylaxis, and the future burden globally.Methods In this modelling study, we used a Delphi process with data from literature reviews and interviews with country experts to quantify the prevalence, diagnosis, treatment, and prevention measures for HBV infection. The PRoGReSs Model, a dyn amic Markov model, was used to estimate the country, regional, and global prevalence of HBV infection in 2022, and the effects of treatment and prevention on disease burden. The future incidence of morbidity and mortality in the absence of additional interventions was also estimated at the global level.Findings We developed models for 170 countries which resulted in an estimated global prevalence of HBV infection in 2022 of 3.2% (95% uncertainty interval 2.7-4.0), corresponding to 257.5 million (216.6-316.4) individuals positive for HBsAg. Of these individuals, 36.0 million were diagnosed, and only 6.8 million of the estimated 83.3 million eligible for treatment were on treatment. The prevalence among children aged 5 years or younger was estimated to be 0.7% (0.6-1.0), corresponding to 5.6 million (4.5-7.8) children with HBV infection. Based on the most recent data, 85% of infants received three-dose HBV vaccination before 1 year of age, 46% had received a timely birth dose of vaccine, and 14% received hepatitis B immunoglobulin along with the full vaccination regimen. 3% of mothers with a high HBV viral load received antiviral treatment to reduce mother-to-child transmission.Interpretation As 2030 approaches, the elimination targets remain out of reach for many countries under the current frameworks. Although prevention measures have had the most success, there is a need to increase these efforts and to increase diagnosis and treatment to work towards the elimination goals.
KW - HEPATOCELLULAR-CARCINOMA
KW - NATURAL-HISTORY
KW - FOLLOW-UP
KW - HBSAG
KW - IMMIGRATION
KW - VIRUS
KW - ELIMINATION
KW - INFECTIONS
KW - WORLDWIDE
KW - CARRIERS
U2 - 10.1016/S2468-1253(23)00197-8
DO - 10.1016/S2468-1253(23)00197-8
M3 - Article
SN - 2468-1253
VL - 8
SP - 879
EP - 907
JO - The Lancet Gastroenterology and Hepatology
JF - The Lancet Gastroenterology and Hepatology
IS - 10
ER -