Recent Research Indicates That We're Falling Short on HBV Elimination Targets
Organizations look at an agent-based model to assess the impact of vaccination, screening, and treatment on incidence and prevalence of HBV in Ontario, Canada.
In 2016, the World Health Assembly made the commitment to eliminate viral hepatitis by 2030. The World Health Organization published their Global Health Sector Strategy on viral hepatitis to articulate specific elimination targets for reaching this goal.
Hepatitis B-related targets include 95% reduction in new chronic hepatitis B (CHB) cases, a 65% reduction in HBV-related deaths, and 80% treatment coverage among eligible patients by 2030.1 A major barrier for achieving these targets, particularly in high-income countries, is lack of a universal birth-dose policy for HBV vaccination.
This results in a major dependence on widespread screening to diagnose and initiate treatment for patients—yet prenatal screening has only been implemented in Canada. Many undiagnosed patients, including those that emigrate from countries with high burdens of HBV, are unaware of their risk of having and spreading HBV and therefore may not be motivated to request screening.
William Wong, PhD, and his research team funded by the Ontario Ministry of Research, Innovation, and Science Early Researcher Award, Natural Sciences and Engineering Research Council (NSERC), and the Canadian Institutes of Health Research (CIHR) utilized an agent-based model to assess the impact of vaccination, screening, and treatment on incidence and prevalence of HBV in Ontario, Canada.
They chose this region to specifically study HBV intervention efforts in a high-income area also affected by continuing immigration from countries with high incidences of HBV. Their modeling study found that current strategies are notably inadequate in reaching elimination targets set by the World Health Organization.2
Undoubtedly, onset of the COVID-19 pandemic served as a significant and recent barrier that detracted from HBV elimination efforts. However, addressing HBV remains a major need. In particular, public liver education needs to be amplified as a necessary component in all efforts to address HBV.
Many people do not have a basic understanding of the importance of their liver, the primary organ impacted by HBV, or how to take care of it. It’s difficult to motivate individuals to seek screening or accept vaccinations against HBV if they are not aware of how the virus can damage liver cells, cause cirrhosis, potentially liver cancer, and a host of other health complications.
The Liver Health Initiative prioritizes liver health education for all children and adults, in efforts to reduce the public health burden of chronic liver-related diseases such as hepatitis and comorbidities including fatty liver disease, obesity, atherosclerosis, type 2 diabetes, high blood pressure, high cholesterol, several types of cancer, and others. Simple story-telling techniques, analogies, and eye-catching materials make liver health personal and memorable for a variety of audiences.
When people know better, they do better
it's important that we harness the power of this wisdom and take concerted steps toward providing a foundation of health literacy to encourage individuals to make healthy decisions. Basic liver health education should be considered an essential component of current and future strategies to eliminate viral hepatitis.
References
1. World Health Organization. (2016). Global health sector strategy on viral hepatitis 2016-2021. Towards ending viral hepatitis. World Health Organization. https://apps.who.int/iris/handle/10665/246177
2. Tian, F., Feld, J. J., Feng, Z., Sander, B., & Wong, W. (2022). Feasibility of hepatitis B elimination in high-income countries with ongoing immigration. Journal of hepatology, 77(4), 947–956. https://doi.org/10.1016/j.jhep.2022.04.014
