Slow path towards elimination of viral hepatitis in Europe

Chronic infection with hepatitis B virus and hepatitis C virus is a major cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma. [SHUTTERSTOCK/Jarun Ontakrai]

Despite the UN aiming to eliminate viral hepatitis by 2030, a report published on Wednesday (15 June) has found that around a quarter of EU/EEA countries don’t have action plans or strategies for the prevention and control of the disease. 

A monitoring survey conducted by the European Centre for Disease Prevention and Control (ECDC), published on Wednesday, revealed that six of the 26 EU/EEA countries observed had no action plan or strategy for viral hepatitis prevention and control. 

Even though the vast majority, 19 countries, had a plan, only 11 had national funding for its implementation. Meanwhile, 22 countries have testing guidance for hepatitis B and C. but many countries’ guidance did not mention one or more of the key populations at most risk from hepatitis infections. 

Cary James, chief executive at the World Hepatitis Alliance, told EURACTIV that there is still “a long way to go to make 2030 goals”.

The goals were set in 2015 when the United Nations adopted the Sustainable Development Goals (SDGs) for 2030 with one of the targets to “end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, waterborne and other communicable diseases”.

This goal was backed up in 2016, when the World Health Assembly endorsed the first Global Health Sector Strategy (GHSS) for viral hepatitis, with the goal to reduce new Hepatitis B and C infections by 90% and deaths by 65% by 2030.

EU countries need to do their homework to eliminate hepatitis by 2030

The world is on a mission to eliminate viral hepatitis as a major public health threat by 2030. But the World Health Organisation has warned that despite positive progress in recent years, “there is still a long way to go”. 

Disparities across the bloc

Chronic infection with hepatitis B virus and hepatitis C virus is a major cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma.

It was estimated in 2017 that nearly 5 million people were living with chronic hepatitis B virus infection and almost 4 million people were living with chronic hepatitis C virus infection in EU/EEA countries and the UK.

In the EU/EEA, deaths attributed to hepatitis B virus and hepatitis C virus are estimated to account for around 55% of liver cancer deaths and 45% of all deaths due to cirrhosis and other chronic liver diseases.

The ECDC report also found disparities when it comes to the number of cases among the countries. The estimated number of people living with chronic hepatitis B virus infection by country varied 18-fold from 183 to 3,312 per 100,000 people. 

In the meantime, the estimated number of people living with current chronic hepatitis C virus infection by country ranged 100-fold from 24 to 2,411 per 100,000. 

Adenovirus, COVID-19 examined as possible cause for mysterious hepatitis

As acute hepatitis cases of unknown origin continue to grow across the globe, the investigation into its origin is ongoing. While the leading hypothesis is adenovirus, the link to COVID-19 is also being looked at. 

No countries are on track for hepatitis B elimination

James said that even though in Europe most countries are on track for the 2030 target of eliminating hepatitis C, the picture is different when it comes to hepatitis B. 

“There’s no country in Europe on track for the hepatitis B elimination targets or any country in the world,” James said.

There is a vaccine available against hepatitis B that can be given at birth, “that could completely eradicate the disease within a generation”. A treatment for stopping the progression to liver cancer or cirrhosis is also available.  

Despite the prevention tools, “the world has been slow to act on hepatitis,” James added.

Last year, World Health Organisation chief Adhanom Ghebreyesus said: “We have the tools to reach these targets, but only if all countries commit to making sure all people have access to them.”

James called on decision-makers to act on hepatitis elimination. “Even Dr Tedros […] said that if there was a disease that we could eliminate by 2030 it is hepatitis,” he concluded.

[Edited by Benjamin Fox/Nathalie Weatherald]

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